[Anterior cervical fusion in the lower cervical spine. Locked vs nonlocked screw plate, pure cancellous bone vs tricortical strut].
Physical alterations in cervical fusions endanger healing. Experimentally we determined less stability loss in fixations using cancellous bone grafts than in those using tricortical grafts. Four hundred eighty-five Patients underwent anterior cervical fusion, for a total of 700 Segments. Patients were divided into four groups: (1) nonlocked H plate with autogenous cancellous bone, (2) nonlocked H plate with autogenous tricortical graft, (3) locked cervical plate with tricortical graft, and (4) stand-alone cage with cancellous bone. Evaluations included X-ray and random CT scan examinations. Our results suggest that anterior cervical fusions using nonlocked H screw plate systems with pure autogenous cancellous bone grafts provide the fastest (6 weeks) and most secure bone healing (P=0.00001), whereas fixations using nonlocked or locked screw plate systems and tricortical autograft require prolonged healing and develop nonunions more frequently. Complete consolidation was achieved using stand-alone cages filled with pure autogenous cancellous bone, but bony healing was delayed due to the cage. Rate of nonunions were: groups 1 and 4 0%, and groups 2 and 3 4.5% and 21%, respectively.
Sándor
L
L
Abteilung für Unfallchirurgie der Medizinischen Universität Albert Szent-Györgyi, Semmelweis u. 6., 6725 Szeged, Ungarn. sandorlaszlodr@freemail.hu
Barzo
P
P
Kuncz
A
A
Elek
P
P
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D019736:Prostheses and Implants; D012086:Reoperation; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013128:Spinal Osteophytosis / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014945:Wound Healing / Q000502:physiology