Chinese Journal Of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (1): 78-84.doi: 10.13418/j.issn.1001-165x.2017.01.016

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Comparative study on the application of two kinds of supports in anterior cervical subtotal corpectomy and fusion of cervical spondylotic myelopathy

PU Zhi-chao1, MA Xiang-yang1, YANG Jin-cheng2,XIA Hong2, WU Zeng-hui2, YIN Qing-shui2,Ai Fu-zhi2, Wang Jian-hua2   

  1. 1. Graduate School of Southern Medical University, Guangzhou 510515, China;  2. Department of Spine Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China
  • Received:2016-10-27 Online:2017-01-25 Published:2017-02-22

Abstract:

Objective To compare the effects of titanium mesh and nano-hydroxyapatite / polyamide 66 (n-HA / PA66) cervical spine bone grafts on cervical spine subtotal resection, decompression fusion, anterior titanium screw fixation, Recovery and maintenance of cervical curvature, intervertebral height and fusion rate, the settlement rate differences. Methods Anterior cervical decompression and fusion were performed in 75 patients with cervical spondylotic myelopathy of two adjacent segments. Forty patients underwent titanium mesh support bone grafting and 35 patients received implantation of nano-hydroxyapatite / polyamide 66 (n-HA / PA66) into the cervical spine. The operative time, intraoperative blood loss, length of hospital stay, JOA score, curvature of cervical vertebrae, height of intervertebral fusion and bone fusion were compared between the two groups. Cobb angle, C2~7 Cobb angle, and D value of the cervical spine were measured before and after the operation, 3,6,9 months follow-up, (HAB) and posterior edge height (HPB) were measured to evaluate the fusion settlement of the support. The differences between the parameters were analyzed by the paired t test. Results All patients were followed up for 9-24 months (mean 16.7 months). The JOA score of the two groups was significantly higher than that of the preoperative group. There was no significant difference in the JOA scores between the two groups (P> 0.05). There was significant difference between the two groups (P <0.05). There was significant difference between the two groups (P<0.05), and there was significant difference (P <0.05) between the two groups at 3, 6, 9 months postoperatively, (P> 0.05), but there was significant difference in the settlement rate at 6 and 9 months after operation (P<0.05). There was obvious early subsidence in the titanium mesh group, which affected the fusion segment vertebrae Between the height.  Conclusion  Nano-hydroxyapatite / polyamide 66 (n-HA / PA66) cervical support has the advantages of improved fusion rate and less complication compared with titanium mesh support bone graft. It can effectively maintain cervical curvature and intervertebral heightand is an ideal support for bone graft material.

Key words: Cervical spondylotic myelopathy, Titanium mesh, Nano-hydroxyapatite/polyamide cervical support, Anterior bone grafting, Measurement