Anterior cervical fusion using vertical self-locking T-graft.
Ninety-three patients with persistent signs and symptoms of cervical disk disorder resistant to conservative therapy were treated surgically by anterior cervical diskectomy and fusion with a vertical self-locking T-graft. This surgical technique offers the following mechanical and physiological advantages: the load-bearing capability of the cortices of the vertical graft supports the cortices of the adjacent vertebral bodies, and prevents anterior wedging postoperative structural collapse; the surgical removal of the cartilaginous end plate and intimate relation between the cancellous bone of the graft and the vertebrae promotes early fusion; the posteriorly positioned prongs of the graft present extrusion; the posterior cortex and posterior longitudinal ligament are not removed, thus minimizing the spinal cord injuries. In a two- to ten-year follow-up, 90% of the patients obtained an excellent of good result. Those with a single level of fusion obtained a far better end result. Complications among these 93 patients were relatively minimal: no instance of anterior collapse or wedging, no evidence of extrusion, no wound or disk space infection, and no neurologic complications occurred. The author recommends this approach when managing selected patients.
D016025:Bone Transplantation; D002574:Cervical Vertebrae; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D011859:Radiography; D013123:Spinal Fusion / Q000379:methods*; D014182:Transplantation, Autologous