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Title: Comparison of multisegment anterior cervical fixation using bone strut graft versus a titanium rod and buttress prosthesis: analysis of outcome with long-term follow-up and interview by independent physician.
Epworth Authors: Brazenor, Graeme
Keywords: Bone Transplantation
Strut Grafting
Cervical Vertebrae
Internal Fixators
Prosthesis Implantation
Spinal Fusion
Cervical Spine Fixation
Osseous Integration
Cervical Corpectomy
Anterior Strut Fixation
Autologous Strut Graft
Cervical Spine Fixation
Titanium Prosthesis
Epworth HealthCare, Victoria, Australia
Issue Date: Jan-2007
Publisher: Lippincott Williams & Wilkins
Citation: Spine (Phila Pa 1976). 2007 Jan 1;32(1):63-71.
Abstract: STUDY DESIGN: A retrospective study of 73 consecutive patients who underwent cervical corpectomy and anterior strut fixation over 3 or more disc levels between July 1989 and May 1999. OBJECTIVE: To compare the efficacy of cervical spine fixation by autologous strut graft from iliac crest or fibula versus a titanium prosthesis without bone graft. SUMMARY OF BACKGROUND DATA: Strut grafting after multilevel anterior cervical corpectomy remains a challenging procedure, with published dislocation rates from 0% to 71%, and nonunion from 0% to 54%. This paper describes a quicker and easier alternative to the use of a bone strut, imparting a very high degree of immediate spinal stability, and osseous integration equivalent to bone fusion. METHODS: Thirty-eight bone-graft operations and 38 titanium prosthesis operations were performed on 73 patients between July 24, 1989 and May 20, 1999. Average follow-up was 53.2 months (range 19.8-134). RESULTS: The group of patients who received the prosthesis was significantly older than the bone-grafted group and required significantly more segments excised, but operation times were significantly shorter than for the bone strut operation. The titanium prosthesis had a lower incidence of dislodgement in the early postoperative period (1/38 vs. 4/38 for bone struts) but a higher rate of late reoperation (4/38 vs. 1/38 for bone struts). The SF-36 scores in the domain of Physical Function (only) were significantly higher in the bone-grafted group (P = 0.016, Mann Whitney), consistent with the difference in mean ages of the 2 groups. The groups were indistinguishable by Odom criteria, patient verdict, pain scores, analgesic intake, length of hospital stay, radiologic fusion rate, and residual symptoms. CONCLUSION: A titanium rod and buttress prosthesis may be a faster and easier alternative to conventional iliac crest/fibula autograft after multisegmental cervical vertebral corpectomy.
DOI: 10.1097/01.brs.0000250304.24001.24
PubMed URL:
ISSN: 0362-2436
Journal Title: Spine
Type: Journal Article
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Musculoskeletal

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