J Korean Soc Spine Surg.  2001 Dec;8(4):468-474.

Change of the Lordosis on Cervical Spine after Anterior Interbody Fusion with Autogenous Iliac Strut Bone Graft

• Ahn JS
• Lee JK
• Yang JY
• Lee HH

Abstract

PURPOSE: Various methods have been used to treat traumas and diseases of the cervical vertebrae. For fractures and diseases of the cervical vertebrae, The authors of this paper sought to evaluate the effectiveness of these different methods by checking for the correction of kyphosis, seeing whether bone graft was successful, making clinical evaluation, and checking for the appropriateness of size and shape of the graft.
METHODS
Of the 193 patients who visited the Department of Orthopedics at Chungnam National University Hopspital from January, 1997, to March, 2000, and had operative treatments using the anterior approach or the Smith-Robinson technique, 161 cases that were possible for follow-up were chosen for this study. Among the cases chosen, 111 cases had cervical trauma, and 50 cases had disease of the cervical vertebrae. Simple X-ray was taken to measure the curvature of the affected area and also of the overall cervical curvature(lower end of the second cervical vertebra-lower end of the seventh cervical vertebra), and the healing of the bone was evaluated.
RESULTS
Normal range of overall cervical curvature is 16~38 degrees of kyphosis; the curvature after operative treatments for diseased cervical vertebrae was corrected back to the normal range from the reduced angles that existed before the operation. The bone graft was healed in all cases except one(cervical disease), and 15 cases showed prolonged healing. For clinical evaluation using the Robinson scale, 109 cases were excellent, 42 cases were good, and 10 cases were fair.
CONCLUSION
Anterior interbody fusion operation of the cervical vertebrae using anterior cervical plate fixation on cases of cervical vertebrate damage and diseases performed, and for the bone graft, using grafts with the anterior surface longer than the posterior surface to induce kyphosis of the cervical vertebrae seemed to be effective. Thus, it is believed that above method is effective in inducing anatomical and functional recovery of patients with trauma and diseases of the cervical vertebrae.

Keyword

Cervical spine; Anterion cervical fuvion; Plate fication; Cervical lordosis

MeSH Terms

Animals
Cervical Vertebrae
Chungcheongnam-do
Female
Follow-Up Studies
Humans
Kyphosis
Lordosis*
Orthopedics
Reference Values
Spine*
Transplants*
Vertebrates

Figure

• 

  Fig. 1. This case is 39 years old man, who is diagnosed Fracture and dislocation C5-6 (A), and then we operated anterior interbody fusion using ORION plate with autogenous strut iliac bone graft(B), and follow up to the postoperative 24 months(C).

• 

  Fig. 2. This case is 33 years old man, who is diagnosed HNP C5-6 (A), and then we operated anterior interbody fusion using ATLANTIS plate with autogenous strut iliac bone graft(B), and follow up to the postoperative 15 months(C).

• 

  Fig. 3. This simple cervical lateral radiograph shows the fact that the “Initiation of bone union” is “Cancellous Portion”.

• 

  Fig. 4. This simple cervical radiograph is the complicated case which was “screw loosening” that is the case which the patient have Cerebral palsy.

Reference

1). Bernad TN, Whitecloud TS III. Treatment of cervical with anterior plating indications, techniques, and results spine. Spine. 16:S38–S44. 1991.

2). Bohler J, Gaudernak T. Anterior plate stabilization for fracture-dislocation of the lower cervical spine. J Traum. 20:203–205. 1980.

3). Bremer AM, Nguyen TQ. Interanl metal plate fixation combined with anterior interbody fusion in cases of cervical spine injury. Neurosurgery. 12:649–653. 1983.

4). Caspar W, Barbier DD, Klara PM. Anterior cervical fusion and Caspar plate stabilization for cervical trauma. Neurosurgery. 25:491–502. 1989.

5). Charles RC. etc:. Differential Diagnosis of cervical Mye-lopathy-Athetoid Dystonic Cerebral Palsy: The Cervical Spine. 3rd. edition. 9The Cervical Spine research society): 165.

6). Durabin FC. Fracture-dislocations of the cervical spine. J Bone Joint Surg. 39-B:23–38. 1957.

7). Farey ID, McAfee PC, Davis RF, Long DM. Pseudoarthrosis of the cervical spine after anterior arthrodesis. J Bone Joint Surg. 72-A:1171–1177. 1990.

8). Gassman J, Seligson D. The anterior cervical plate. Spine. 8:700–707. 1983.

9). Gore DR, Sepic SB. Anterior cervical fusion for degenerated or protruded discs, A review of one jundred forty-six patients. Spine. 9:667–671. 1986.

10). Jacob B. Cervical fractures and dislocations(C3-C7), Clin Ortho. 109:18–31. 1975.

11). Jacob RR, Asher , Sneider RK. A comparative study Spine. 5:463–477. 1980.

12). Naito M, Kurose S, Oyama M, Sugioka Y. Ant erior cervical fusion with the Caspar instrumentation system. In Orthop. 17:73–76. 1993.

13). Park HJ, Na JH, Yoon YS. Anterior cervical interbod fusion using cervical locking plate(CLSP), JKOA, 31-. 1:52–57. 1996.

14). Robinson RA, Smith GW. Anterolateral cervical disc removing and interbody fusion for cervical disc syn drome. Bull John Hopkins Hospital. 96:223–224. 1955.

15). Suh PB, Kostuik JP, Esses SI. Anterior cervical A preliminary report. Spine. 15(10):1079–1081. 1990.

16). Sutterlin CE 3rd, Mcafee PC, Warden KF, Rey RM Jr., Farey ID. A biomechanical evaluation of cervical spinal stabilization methods in a bovine model. Spine. 13:795–802. 1988.

17). Wang JM, Kim DJ. Anterior cervical interbody fusion using cervical spine locking plate, CSLP), JKOA, 32-. 1:8–15. 1997.

18). Zdeblick TA, Cooke ME, Kunz DN, Wilson D, Ma-Cabe RP. Anterior cervical discectomy and fusion using a porous hydroxyapatite bone graft substitute. Spine. 19:2348–2357. 1994.