Cervical stabilization by plate and bone fusion.
Anterior stabilization with combined plate and bone fusion was performed after neural decompression on ten patients for spondylotic cervical myelopathy, and for radiculopathy or trauma in three patients. Medial corpectomy was performed at one to four levels. Iliac crest or fibular bone grafts were secured by plates anchored to the graft and adjacent vertebral bodies. All patients were placed in Minerva braces postoperatively. There was successful fusion in all cases, and no graft dislodgement or kyphosis. Early initiation of rehabilitation was achieved. Morbidity occurred in patients with severe spondylotic cervical myelopathy. This include respiratory depression requiring reintubation in 2/13 procedures, dysphagia (2/13) from loosening of the screws or prominent hardware and graft, and screw loosening (2/13). Neurological improvement was present in 85% (11/13) of patients. There was no deterioration of neurological function in any case. We conclude from this early follow-up that anterior bone fusion with supplemental plates provides effective stabilization for the unstable cervical spine. Greater morbidity risk exists in patients with severe spondylotic cervical myelopathy and spastic quadriparesis who required multilevel medial corpectomies and fusion.
Brown
J A
JA
Department of Neurological Surgery, Medical College of Ohio, Toledo.
Havel
P
P
Ebraheim
N
N
Greenblatt
S H
SH
Jackson
W T
WT
D000328:Adult; D000368:Aged; D001860:Bone Plates; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009192:Myelography; D009333:Neck / Q000000981:diagnostic imaging; D009422:Nervous System Diseases / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications; D013118:Spinal Cord Diseases / Q000503:physiopathology / Q000601:surgery; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000601:surgery; D013123:Spinal Fusion; D013126:Spinal Nerve Roots; D014057:Tomography, X-Ray Computed