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Surgical Reconstruction Using a Flanged Mesh Cage without Plating for Cervical Spondylotic Myelopathy and a Symptomatic Ossified Posterior Longitudinal Ligament

Journal of Korean Neurosurgical Society 2019년 62권 6호 p.671 ~ 680
강정훈, 임수빈, Yang Sang-Mi, 정문영, 정제훈, 김범태, 황선철, 신동성, 박종현,
소속 상세정보
강정훈 ( Kang Jung-Hoon ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery
임수빈 ( Im Soo-Bin ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery
 ( Yang Sang-Mi ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery
정문영 ( Chung Moon-Young ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery
정제훈 ( Jeong Je-Hoon ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery
김범태 ( Kim Bum-Tae ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery
황선철 ( Hwang Sun-Chul ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery
신동성 ( Shin Dong-Seong ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery
박종현 ( Park Jong-Hyun ) - Soonchunhyang University College of Medicine Soonchunhyang University Bucheon Hospital Department of Neurosurgery

Abstract


Objective: We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL).

Methods: Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom’s criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months.

Results: In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom’s criteria or between the single-level and two-level corpectomy groups.

Conclusion: The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction.

키워드

Cervical vertebrae; Ossification of posterior longitudinal ligament; Spondylosis; Titanium

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