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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 appropri-ateness 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 followup were chosen for this study. A mong 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
A nterior 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.
REFERENCES
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Figures and Tables%
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.
Table 1-1.
Change of the cervical lordosis(Trauma)
| Initial | Postop | Last F/U | |
|---|---|---|---|
| Involve Segment | –6.7 | 5.61 | 4.76 |
| C2 - C7 | 15.26 | 19.29 | 20.23 |
Table 1-2.
Change of the cervical lordosis(Trauma)(Angle-Correction of cervical lordosis)
| Initial-Postop | Initial-Last F/U | |
|---|---|---|
| Involve Segment | 7.28 | 6.43 |
| C2-C7 | 4.03 | 4.97 |
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