Data from: Fresh frozen cortical strut allograft in two-level anterior cervical corpectomy and fusion

Anterior cervical corpectomy and fusion (ACCF) is one of the main surgical strategies for the management of multilevel cervical spondylotic myelopathy (MCSM). High complication rates of graft bone fracture, resorption, displacement, and fusion collapse or pseudarthrosis have been previously reported. The strategies to prevent the aforementioned complications include using fresh frozen cortical strut allograft (FFCSA) to keep most of the original bone quality and using additional anterior plate fixation to improve the fusion stability and union rate. In this study, we evaluated 4-year follow-ups for surgical outcomes and analyzed the risk factors of MCSM patients who received 2-level ACCF with FFCSA and titanium dynamic plate fixation. We retrospectively collected preoperative and postoperative radiographic and clinical data of patients from 2005 to 2009; the inclusion criteria were having been diagnosed as MCSM and having received 2-level ACCF with an FFCSA fibular shaft and an anterior dynamic plate. The cervical curvature lordosis improved and the neurogenic function recovered well postoperatively. Visual analog scale for neck pain and neck disability index scores both decreased after 12 and 48 months following surgery. The Japanese Orthopaedic Association score recovery rate at postoperative 4 years was 87.5%. Fusion rates achieved 100% at 12 months. The preoperative Nurick score seemed to be the only significant risk factor correlated with the functional recovery rate at 4 years after the surgery. In conclusion, based on a minimum 4-year follow-up of 2-level ACCF with FFCSA and dynamic titanium plates for patients with MCSM, the surgical results were satisfying and the complication rates were low.

颈椎前路椎体次全切除融合术（Anterior cervical corpectomy and fusion, ACCF）是治疗多节段脊髓型颈椎病（multilevel cervical spondylotic myelopathy, MCSM）的主要手术策略之一。既往研究已报道该术式存在较高的并发症发生率，包括移植骨骨折、吸收、移位以及融合塌陷或假关节形成。针对上述并发症的防治策略包括采用新鲜冷冻皮质支撑同种异体移植物（fresh frozen cortical strut allograft, FFCSA）以保留大部分原有骨质量，以及附加前路钢板固定以提升融合稳定性与融合率。本研究针对接受2节段ACCF联合FFCSA腓骨支撑与钛合金动态钢板固定的MCSM患者，开展了为期4年的随访以评估手术结局，并分析其危险因素。研究回顾性收集了2005年至2009年入组患者的术前及术后影像学与临床资料，纳入标准为确诊为MCSM且接受该术式的患者。术后患者颈椎前凸曲度得到改善，神经功能恢复良好；术后12个月与48个月时，颈痛视觉模拟评分（Visual Analog Scale, VAS）与颈部功能障碍指数（Neck Disability Index, NDI）评分均较术前显著降低。术后4年日本骨科协会（Japanese Orthopaedic Association, JOA）评分恢复率达87.5%；术后12个月融合率达100%。分析显示，术前努里克评分（Nurick Score）似乎是唯一与术后4年功能恢复率相关的显著危险因素。综上，基于对接受2节段ACCF联合FFCSA与钛合金动态钢板固定治疗的MCSM患者开展的至少4年随访结果，该手术的治疗效果令人满意，且并发症发生率较低。