18 21 2014 05 21 Chinese Journal of Tissue Engineering Research May 21, 2014 Vol.18, No.21 ( 100034) 1 2 68 32 36 3 94% 97% 6 3 6 12 1977 2006 100034 doi:10.3969/j.issn.2095-4344. 2014.21.003 [http://www.crter.org] :R318 :A :2095-4344 (2014)21-03293-06 2014-04-26.[J]. 2014 18(21):3293-3298. 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 100034, 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):3293-3298. Li Hong, M.D., Associate chief physician, Department of Orthopedics, Peking University First Hospital, Beijing 100034, China Corresponding author: Li Chun-de, Chief physician, Doctoral supervisor, Department of Orthopedics, Peking University First Hospital, Beijing 100034, China Accepted: 2014-04-26 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 3293
. 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] 2010 5 2012 4 1Subjects and methods 2010 5 2012 4 MRIC 3 C 7 6832 38 65 6 24 8.3 C 3/4 6 C 4/5 10 C 5/6 9 C 6/7 7 3635 62 8 20 7.6 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 1 3 6 12 XX6 CT MRI 2 [3] Borden C 7 () [21] SPSS 15.0 t P < 0.05 3294 P.O. Box 10002, Shenyang 110180
. 2Results 2.1 68 2.2 1 2.3 JOA JOA (P < 0.05) JOA (P < 0.05) JOA JOA(P > 0.05)2 JOA2411 1 97% 2111 100% 2.4 397%(31/32) 94%(34/36) (P > 0.05) 63 3 6 12 (P > 0.05) (P > 0.05) 2.5 1 34 7 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) 2 44 6 2 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) 2.6 6 2 3Discussion 1958 Smith [3] Cloward [4] 50 [22-24] [25-26] [27-28] 10% 20% [29] [30] [31-33] 26% 44% [8 13 25 34] [4 11 19 26] [23 24 27] 3 Solis Solis 3 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 3295
. 1 Table 1 Comparison of baseline data between two groups (n=32) (n=36) P (x _ ±s ) 51.5±13.6 52.6±13.2 1.326 / (n) 12/20 15/21 2.232 (x _ ±s kg/m 2 ) 23.2±2.7 21.8±4.1 1.098 (n) C 3/4 6 5 C 4/5 10 9 C 5/6 9 12 C 6/7 7 10 (x _ ±s min) 76±10 52±8 0.001 (x _ ±s ml) 45±12 13±12 0.001 (x _ ±s ) 16±5 16±4 3.220 2 JOA Table 2 Comparison of clinical scores on the Japanese Orthopaedic Association scale in the two groups before and after treatment P 7.8 15.4 83% 8.1 15.3 81% 2.332 1.690 1.437 3 Table 3 Comparison of imaging results between the two groups at different time after treatment (x _ ±s, mm) 7.7±0.4 5.5±0.3 7.4±0.3 5.7±0.5 3 7.6±0.5 5.4±0.2 7.2±0.4 5.5±0.4 6 7.4±0.7 5.2±0.6 6.8±0.6 5.2±0.5 12 7.2±0.3 5.0±0.3 6.5±0.8 4.9±0.5 3 6 12 (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 110180
. 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 90 170 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):941-951. [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): 208-216. [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):607-624. [4] Cloward RB.The anterior approach for removal of ruptured cervical disks. J Neurosurg.1958;15(6):602-617. ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 3297
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