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Servikal Füzyon için Alternatif Bir Teknik, Dairesel Şekilde Yerleştirilen Kemik Grefti: Teknik Not

Year 2022, Volume: 4 Issue: 1, 29 - 33, 27.02.2022
https://doi.org/10.52827/hititmedj.943293

Abstract

Spinal stabilizasyonda son derece gelişmiş spinal implantlara ve cerrahi tekniklere rağmen günümüzde halen kaynamama en önemli sorunu teşkil etmektedir. Spinal füzyonun başarısında rol alan faktörler arasında, greft materyalinin tipi, füzyon alanının greft dokusu ile mümkün olan en geniş yüzeyde teması, çevre kas ve yumuşak doku ile füzyona uğrayacak kemik dokuların uçlarının kanlanmalarının iyi olması, füzyona uğrayacak kemik dokuların hareketinin engellenmesi, füzyonu hedeflenen alana uygun greft dokusunun yerleştirilmesi sayılabilir. Bu nedenle, füzyon oluşumunun temel şartlarından biri olan geniş kemik-greft alanının oluşturulabilmesini amaçlayan alternatif bir kafes- greft yerleştirme tekniğini geliştirip kullanarak radyolojik ve klinik takipini değerlendirdik. Uyguladığımız bu yeni alternatif teknikte, plaklı servikal korpektomi kafesinin anterior ve lateral yüzlerini temas edip dairesel tarzda tamamen dolduran greft materyalinin, bu şekilde yerleştirme sonrasında radyolojik olarak dairesel tarzda kemik füzyon oluşturduğunu gözlemledik. Bu graft yerleştirme şeklinin olası instabiliteyi azaltacağı düşünmekteyiz.

References

  • 1. Steinmann J, Herkowitz H. Pseudarthrosis of the spine. Clinc Orthop 1992; 284:80.
  • 2. Jerome MC, Andrew MS. Complications of spinal fusion. New york: Springer Verlag 1990;361-387.
  • 3. Chou D, Lu DC, Weinstein P et al. Adjacent-level vertebral body fractures after expandable cage reconstruction. J Neurosurg Spine 2008;8:584-588.
  • 4. Liu X, Wang H, Zhou Z et al. Anterior decompression and fusion versus posterior laminoplasty for multilevel cervical compressive myelopathy. Orthopedics 2014;37:117-122.
  • 5. Wada E, Suzuki S, Kanazawa A et al. Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy: a long-term follow-up study over 10 years. Spine 2001;26:1443-1447.
  • 6. Thome C, Krauss JK, Zevgaridis DA. Prospective clinical comparison of rectangular titanium cages and iliac crest autografts in anterior cervical discectomy and fusion. Neurosurg Rev 2004;27:34-41.
  • 7. Hwang SL, Lee KS, Su YF. Anterior corpectomy with iliac bone fusion or discectomy with interbody titanium cage fusion for multilevel cervical degenerated disc disease. J Spinal Disord Tech 2007;20:565-570.
  • 8. Park DH, Ramakrishnan P, Cho TH et al. Effect of lower two-level anterior cervical fusion on the superior adjacent level. J Neurosurg Spine 2007;7:336-340.

An Alternative Technic for Cervical Fusion, Circularly Placed Bone Graft: Technical Note

Year 2022, Volume: 4 Issue: 1, 29 - 33, 27.02.2022
https://doi.org/10.52827/hititmedj.943293

Abstract

Despite the highly developed spinal implants and surgical techniques in spinal stabilization, fusion failure is still the most important problem today. Among the factors that play a role in the success of spinal fusion, are type of graft material, contact of the fusion area with the graft tissue on the widest possible surface, good blood supply of the ends of the bone tissue that will fuse with the surrounding muscle and soft tissue, prevention of the movement of bone tissues that will be fused and placement of appropriate graft tissue in the targeted area for fusion. Therefore, we have developed and evaluated the radiological and clinical follow-up of an alternative cage - graft placement technique aimed at creating a large bone-graft area, which is one of the main conditions for the formation of fusion, and using it. In this new alternative technique we applied, we observed that the graft material that contacted the anterior and lateral faces of the cervical corpectomy cage with plates and completely filled them in a circular style formed a radiologically circular-style bone fusion after placement in this way. We believe that this graft placement will reduce possible instability.

References

  • 1. Steinmann J, Herkowitz H. Pseudarthrosis of the spine. Clinc Orthop 1992; 284:80.
  • 2. Jerome MC, Andrew MS. Complications of spinal fusion. New york: Springer Verlag 1990;361-387.
  • 3. Chou D, Lu DC, Weinstein P et al. Adjacent-level vertebral body fractures after expandable cage reconstruction. J Neurosurg Spine 2008;8:584-588.
  • 4. Liu X, Wang H, Zhou Z et al. Anterior decompression and fusion versus posterior laminoplasty for multilevel cervical compressive myelopathy. Orthopedics 2014;37:117-122.
  • 5. Wada E, Suzuki S, Kanazawa A et al. Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy: a long-term follow-up study over 10 years. Spine 2001;26:1443-1447.
  • 6. Thome C, Krauss JK, Zevgaridis DA. Prospective clinical comparison of rectangular titanium cages and iliac crest autografts in anterior cervical discectomy and fusion. Neurosurg Rev 2004;27:34-41.
  • 7. Hwang SL, Lee KS, Su YF. Anterior corpectomy with iliac bone fusion or discectomy with interbody titanium cage fusion for multilevel cervical degenerated disc disease. J Spinal Disord Tech 2007;20:565-570.
  • 8. Park DH, Ramakrishnan P, Cho TH et al. Effect of lower two-level anterior cervical fusion on the superior adjacent level. J Neurosurg Spine 2007;7:336-340.
There are 8 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Ahmet Gürhan Gürçay 0000-0002-8810-938X

Hümeyra Kullukçu Albayrak 0000-0003-0675-8288

Publication Date February 27, 2022
Submission Date May 26, 2021
Acceptance Date October 22, 2021
Published in Issue Year 2022 Volume: 4 Issue: 1

Cite

AMA Gürçay AG, Kullukçu Albayrak H. An Alternative Technic for Cervical Fusion, Circularly Placed Bone Graft: Technical Note. Hitit Medical Journal. February 2022;4(1):29-33. doi:10.52827/hititmedj.943293