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1 Chinese Journal of Tissue Engineering Research May 21, 2014 Vol.18, No.21 ( ) % 97% doi: /j.issn [ :R318 :A : (2014) [J] (21): Anterior cervical discectomy and fusion by cervical cage with bioactive glass Li Hong, Li Chun-de, Yi Xiao-dong, Liu Hong (Department of Orthopedics, Peking University First Hospital, Beijing , China) Abstract BACKGROUND: Bioactive glass has been largely reported to have perfect clinical results in the bone nonunion and fracture healing, but its effect during spinal fusion progress is rarely reported. OBJECTIVE: To explore the safety and effectiveness of anterior cervical discectomy and fusion by cervical cage with bioactive glass METHODS: A total of 68 cases of cervical spondylosis myelopathy were treated with single level anterior cervical discectomy and fusion. Their clinical data were retrospectively analyzed. All the cases underwent polyetheretherketone cervical cage with autogenous bone (n=32, control group) or bioactive glass (n=32, experimental group). The bone fusion, neurological functional recovery, intervertebral height, change of cervical curve and wound complications in the two groups was recorded and analyzed. RESULTS AND CONCLUSION: Neurological improvement had no difference between the two groups and there was no complication about wound, such as infection and delayed healing. The average rate of bone fusion was 97% in the control group while 94% in the experiment group 3 months after operation which had no significant differences. Six months after operation, all cases gained bone fusion. The intervertebral height and change of cervical curve both maintained well in the two groups within 3, 6, 12 months after operation which had no significant differences between the two groups. So, anterior cervical discectomy and fusion by cervical cage with bioactive glass is safe and effective. Subject headings: glass; cervical vertebrae; spinal fusion Li H, Li CD, Yi XD, Liu H. Anterior cervical discectomy and fusion by cervical cage with bioactive glass. Zhongguo Zuzhi Gongcheng Yanjiu. 2014;18(21): Li Hong, M.D., Associate chief physician, Department of Orthopedics, Peking University First Hospital, Beijing , China Corresponding author: Li Chun-de, Chief physician, Doctoral supervisor, Department of Orthopedics, Peking University First Hospital, Beijing , China Accepted: ISSN CN /R CODEN: ZLKHAH 3293

2 . 0 Introduction [1-2] [3-4] 1 2 [5] [6-7] X 3 X [8] [9-10] [2 6 11] [12-15] N 2 O CaO SiO 2 P 2 O 5 [16-18] [19-20] Subjects and methods MRIC 3 C C 3/4 6 C 4/5 10 C 5/6 9 C 6/ C 3/4 5 C 4/5 9 C 5/6 12 C 6/7 10 CT MRI Stryker Solis 5 ml 5 cm X 1 24 h 2 3 d 6 8 JOA JOA =( )/(17 ) 100% >75%50% 75% 25% 49%<25% [21] XMRI X XX6 CT MRI 2 [3] Borden C 7 () [21] SPSS 15.0 t P < P.O. Box 10002, Shenyang

3 . 2Results JOA JOA (P < 0.05) JOA (P < 0.05) JOA JOA(P > 0.05)2 JOA % % %(31/32) 94%(34/36) (P > 0.05) (P > 0.05) (P > 0.05) C 5/6 ( 1A) MRI C 5/6 ( 1B)JOA 8 Styker Solis 5 ml 55 min 15 ml 2 JOA 16 ( 1C)3 ( 1D) ( 1E) MRI ( 1F) C 5/6 ( 2A)MRI C 5/6 ( 2B) JOA 9 Styker Solis 5 ml 75 min 55 ml 2 JOA 15 ( 2C)3 ( 2D) CT ( 2E F) MRI ( 2G) Discussion 1958 Smith [3] Cloward [4] 50 [22-24] [25-26] [27-28] 10% 20% [29] [30] [31-33] 26% 44% [ ] [ ] [ ] 3 Solis Solis 3 ISSN CN /R CODEN: ZLKHAH 3295

4 . 1 Table 1 Comparison of baseline data between two groups (n=32) (n=36) P (x _ ±s ) 51.5± ± / (n) 12/20 15/ (x _ ±s kg/m 2 ) 23.2± ± (n) C 3/4 6 5 C 4/ C 5/ C 6/ (x _ ±s min) 76±10 52± (x _ ±s ml) 45±12 13± (x _ ±s ) 16±5 16± JOA Table 2 Comparison of clinical scores on the Japanese Orthopaedic Association scale in the two groups before and after treatment P % % Table 3 Comparison of imaging results between the two groups at different time after treatment (x _ ±s, mm) 7.7± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± (P > 0.05) (P > 0.05) A B C D E F 1 34 Figure 1 Imaging pictures of a male patient, 34 years old, undergoing anterior cervical discectomy and fusion by cervical cage with bioactive glass A X C 5/6 B MRI C D 3 E 3 F 3 MRI 3296 P.O. Box 10002, Shenyang

5 . A B C D E F G 2 44 Figure 2 Imaging pictures of a female patient, 44 years old, undergoing anterior cervical discectomy and fusion by cervical cage with autogenous bone A X C 5/6 B MRI C 5/6 C X C 5/6 D 3 X E 3 CT F 3 CT G 3 MRI μm [35-36] [27-28] 6 4 References [1] Emery SE,Bohlman HH,Bolesta MJ,et al.anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy:two to seventeen-year follow-up.j Bone Joint Surg Am.1998;80(7): [2] Lin CN,Wu YC,Wang NP,et al.preliminary experience with anterior interbody titanium cage fusion for treatment of cervical disc disease.kaohsiung J Med Sci. 2003;19(5): [3] Smith GW,Robinson RA.The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion.j Bone Joint Surg Am.1958;40-A(3): [4] Cloward RB.The anterior approach for removal of ruptured cervical disks. J Neurosurg.1958;15(6): ISSN CN /R CODEN: ZLKHAH 3297

6 . [5] Suetsuna F,Yokoyam T,Kenuka E,et al.anterior cervical fusion using porous hydroxyapatite ceramics for cervical disc herniation.a two-year follow-up. Spine J. 2001;1: [6] McDuffee LA,Anderson GI.In vitro comparison of equine cancellous bone graft donor sites and tibial periosteum as sources of viable osteoprogenitors.vet Surg. 2003;32: [7] Thalgott JS,Xiongsheng C,Giuffre JM.Single stage anterior cervical reconstruction with titanium mesh cages,local bone graft, and anterior plating. Spine J.2003;3: [8] Yue WM,Brodner W,Highland TR.Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study.spine (Phila Pa 1976).2005;30: [9] Hodges SD,Humphreys SC, Eck JC,et al.a modified technique for anterior multilevel cervical fusion.j Orthop Sci. 2002;7: [10] Fraser JF,Hartl R.Anterior approaches to fusion of the cervical spine: a metaanalysis of fusion rates.j Neurosurg Spine. 2007; 6: [11] Scholz M,Schnake KJ,Pingel A,et al.a new zero-profile implant for standalone anterior cervical interbody fusion.clin Orthop Relat Res.2011;469: [12] Yue WM,Brodner W,Highland TR.Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study.eur Spine J.2005;14: [13] Smith-Hammond CA,New KC,Pietrobon R,et al.prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures.spine (Phila Pa 1976). 2004; 29: [14] Mayr MT,Subach BR,Comey CH,et al.cervical spinal stenosis: outcome after anterior corpectomy, allograft reconstruction, and instrumentation.j Neurosurg. 2002;96: [15] Miller LE,Block JE.Safety and effectiveness of bone allografts in anterior cervical discectomy and fusion surgery.spine (Phila Pa 1976).2011;36: [16] Virk S,Sandhu HS,Khan SN.Cost effectiveness analysis of graft options in spinal fusion surgery using a Markov model.j Spinal Disord Tech.2012;25:E [17] Zhou J,Xia Q,Dong J,et al.comparison of stand-alone polyetheretherketone cages and iliac crest autografts for the treatment of cervical degenerative disc diseases. Acta Neurochir(Wien).2011;153: [18] Patel NP,Wolcott WP,Johnson JP,et al.esophageal injury associated with anterior cervical spine surgery.surg Neurol.2008;69(1):20-24; discission 4. Epub 2007/11/03. [19] Buttermann GR.Prospective nonrandomized comparison of an allograft with bone morphogenic protein versus an iliac-crest autograft in anterior cervical discectomy and fusion.spine J.2008;8: [20] Sansur CA,Early S,Reibel J,et al.pharyngocutaneous fistula after anterior cervical spine surgery.eur Spine J. 2009;18(5): [21] Rafael H.Cervical spondylotic myelopathy: surgical results and factors affecting outcome with special reference to age differences.neurosurgery.2003;53:787. [22] Matz PG,Anderson PA,Holly LT,et al.the natural history of cervical spondylotic myelopathy.j Neurosurg Spine.2009;11: [23] Yan D,Wang Z,Deng S,et al.anterior corpectomy and reconstruction with titanium mesh cage and dynamic cervical plate for cervical spondylotic myelopathy in elderly osteoporosis patients.arch Orthop Trauma Surg. 2011;131: [24] Amaral SH,Silva MN,Giraldi M,et al.multiple cervical arcocristectomies for the treatment of cervical spondylotic myelopathy: surgical technique and results. J Neurosurg Spine.2007;7: [25] Hwang SL,Lee KS,Su YF,et al.anterior corpectomy with iliac bone fusion or discectomy with interbody titanium cage fusion for multilevel cervical degenerated disc disease.j Spinal Disord Tech.2007;20: [26] Liu Y,Hou Y,Yang L,et al.comparison of three reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy.spine (Phila Pa 1976). 2012;37: E1450-E1458. [27] Azab W,Abdel-Razek M,Ali A,et al.outcome evaluation of a zeroprofile implant for anterior cervical diskectomy with fusion. Turk Neurosurg.2012;22: [28] Kristof RA,Kiefer T,Thudium M,et al.comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral level spondylotic cervical myelopathy. Eur Spine J.2009;18: [29] Hussain M,Natarajan RN,Fayyazi AH,et al.screw angulation affects bone-screw stresses and bone graft load sharing in anterior cervical corpectomy fusion with a rigid screw-plate construct: a finite element model study.spine J. 2009;9: [30] Marawar S,Girardi FP,Sama AA,et al.national trends in anterior cervical fusion procedures.spine (Phila Pa 1976). 2010;35: [31] Angevine PD,Arons RR,McCormick PC.National and regional rates and variation of cervical discectomy with and without anterior fusion, Spine (Phila Pa 1976). 2003;28: [32] Jiang SD,Jiang LS,Dai LY.Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion for multilevel cervical spondylosis: a systematic review.arch Orthop Trauma Surg.2012;132: [33] Daniels AH,Riew D,Yoo JU,et al.adverse events associated with anterior cervical spine surgery.j Am Acad Orthop Surg. 2008;16: [34] Yang B,Li H,Zhang T,et al.the incidence of adjacent segment degeneration after cervical disc arthroplasty (CDA): a meta analysis of randomized controlled trials. PLoS One. 2012;7: e [35] Klein GR,Vaccaro AR,Albert TJ.Health outcome assessment before and after anterior cervical discectomy and fusion for radiculopathy: a prospective analysis. Spine (Phila Pa 1976). 2000;25: [36] Hillard VH,Apfelbaum RI.Surgical management of cervical myelopathy: indications and techniques for multilevel cervical discectomy.spine J.2006;6:242S-251S P.O. Box 10002, Shenyang

Microsoft Word - 1899-1903谢虹5.0.DOC

Microsoft Word - 1899-1903谢虹5.0.DOC 中国组织工程研究第 19 卷第 12 期 2015 03 19 出版 Chinese Journal of Tissue Engineering Research March 19, 2015 Vol.19, No.12 聚丙烯补片在改良盆底重建修复盆腔脏器脱垂中的应用谢虹 1,2, 黄海伟 1, 马新 1, 赵芳 1,