Effectiveness of the New Modified Smith-Robinson Bone Graft for Cervical Anterior Interbody Fusion

Dong-Hee Kim; Soon-Taek Jeong; Sung-Hwan An; Hyung-Bin Park; Sun-Chul Hwang; Se-Hyun Cho

doi:10.4055/jkoa.2008.43.1.101

Journal List > J Korean Orthop Assoc > v.43(1) > 1012748

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Kim, Jeong, An, Park, Hwang, and Cho: Effectiveness of the New Modified Smith-Robinson Bone Graft for Cervical Anterior Interbody Fusion

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(1): 101-106.

Published online: 29 February 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.1.101

Effectiveness of the New Modified Smith-Robinson Bone Graft for Cervical Anterior Interbody Fusion

Dong-Hee Kim, M.D., Soon-Taek Jeong, M.D., Sung-Hwan An, M.D., Hyung-Bin Park, M.D., Sun-Chul Hwang, M.D., Se-Hyun Cho, M.D.

Department of Orthopaedic Surgery, School of Medicine, Gyeongsang National University, Jinju, Korea.

Address reprint requests to Soon-Taek Jeong, M.D. Department of Orthopaedic Surgery, School of Medicine, Gyeongsang National University, 90, Chilam-dong, Jinju 660-702, Korea. Tel: +82.55-750-8101, Fax: +82.55-754-0477, ssurgeon@nongae.gsnu.ac.kr

Abstract

Purpose

We attempted to evaluate the effectiveness of the new modified Smith-Robinson bone graft method for performing cervical anterior interbody fusion.

Materials and Methods

Forty-two patients had anterior interbody fusion on the cervical spine, using an anterior approach and the new modified Smith-Robinson's method (NMSR), between September 2001 and June 2006. There were 30 males and 12 females, with an average age of 51.2 years and the mean follow up period was 39.5 months. We measured the area from C4 to C6 in 32 cases. This was compared with the contact area of the bone graft of the NMSR method and the Original Smith-Robinson method (OSR). We also checked the time to bone union and changes of Cobb's angle at the final follow-up to evaluate the effectiveness of the NMSR.

Results

Bony fusion was obtained in all cases. The average size of the OSR were 169 and 152 mm², in the males and females respectively, whereas those of the NMSR were 263, and 228 mm². Therefore, the average size of the NMSR increased to 94 mm² and 76 mm² than those of the OSR method in the males and females. The average time to radiological bone union was 9.6 weeks and the changes of Cobb's angle at final follow-up were 2.5±2.6°.

Conclusion

The NMSR technique was a very effective method for cervical anterior interbody fusion. It could enlarge the bone graft size about 50-56% compared with the OSR technique. It also shortened the period of bone union and also increased the bone union rate.

Keywords: New modified Smith-Robinson technique, Smith-Robinson technique, Cervical interbody fusion, Bone graft, Bone union

Figures and Tables

Fig. 1

Auto-iliac tricortical strut bone graft and photograph after insertion of bone graft by the New Modified Smith-Robinson technique.

Fig. 2

Comparison of area of the Cervical spine for the Original Smith-Robinson method & the New modified Smith-Robinson bone graft method.

Fig. 3

Postoperative AP, Lateral radiographs and axial view of CT of the NMSR bone graft.

Table 1

Average Dimensions of the Endplate of the Cervical Spine

Table 2

Average Bone Graft Size

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