The use of autologous cervical laminae as bone graft in anterior cervical discectomy and fusion in patients undergoing one-stage posteroanterior cervical surgery / 解放军医学杂志

ABSTRACT

Objective To evaluate the effectiveness and radiographic outcomes of using autologous cervical laminae as bone graft in anterior discectomy and fusion (ACDF) in patients with one-stage posteroanterior surgery for cervical spinal stenosis (cervical spondylotic myelopathy). Methods From January 2010 to June 2013, 37 patients with cervical spinal stenosis underwent surgical treatment in our hospital. Fifteen of them underwent one-stage posteroanterior cervical surgery using autologous cervical laminae as bone graft in ACDF (group A), and 22 patients underwent one-stage posteroanterior procedure using autologous iliac bone as bone graft in ACDF (group B). The operative time, intraoperative blood loss, fusion rate, VAS score, JOA score and height of intervertebral space were compared between the two groups. Results The operative time was 102.7 ± 13.9 min in group A and 128.9 ± 12.3 min in group B, showing significant difference between two groups (t=-6.031, P=0.00). The intraoperative blood loss was 170.3 ± 25.7 ml in group A and 191.1 ± 32.0 ml in group B, and also showing significant difference between them (t=-2.097, P=0.04). All the patients were followed up from 6 months to 42 months (mean, 17.4 months). At 6 months after the surgery, the fusion rate of bone graft was 94.4% (14/15) in group A and 100% (22/22) in group B, and no significant difference was found between two groups (χ2 =1.507, P=0.220). The postoperative VAS score, JOA score and intervertebral height were significantly improved compared with those before surgery in both groups (P0.05). Conclusion In anterior cervical discectomy and fusion during one-stage posteroanterior cervical surgery, the use of autologous cervical laminae as bone graft is feasible.