Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2017; 84(6):448-452 | DOI: 10.55095/achot2017/069

Augmentace krční páteře kostním cementem - technika ke zlepšení stability fixace krční páteře dlahouPůvodní práce

E. BAYLEY¹, Z. KLEZL Jr.^2,*, R. BOMMIREDY³, Z. KLEZL Sr.³

¹ The Centre for Spinal Studies and Surgery, Queens Medical Centre, Nottingham, UK

² Department of Orthopaedics and Traumatology, 3rd Medical school, Charles' University, Prague, Czech Republic

³ Department of Trauma and Orthopaedics, Royal Derby Hospital, Derby, UK

PURPOSE OF THE STUDY:
The aim of this study is to describe a new technique for cement augmentation of primary anterior cervical screw fixation in the sub-axial cervical spine.

MATERIAL AND METHODS:
Seven patients underwent anterior cervical spine surgery for trauma (two) or tumor infiltration (five) between 2008 and 2015. The tumor cases underwent corpectomy and anterior plating, with the trauma cases undergoing anterior cervical decompression and fusion using iliac crest bone graft. All surgeries were performed through the standard anterior approach. 0.2-0.25 ml of Kyphon cement were introduced into the screw holes before the screws were locked into the plate of the anterior construct. Karnofsky Index, Spinal Instability Neoplastic score (SINS) were calculated and radiographic follow-up performed.

RESULTS:
Median follow-up was 7 months (range 7 weeks-39 months). There were no complications from cement leakage or construct failure during the follow-up period. There were no wound infections or approach-related complications. We did not have to re-operate on any patient, cervical spine remained stable until the end of follow up.

DISCUSSION:
Until now a limited number of papers on cement augmentation of cervical spine mainly dealt with revision surgeries, when cement was used as rescue technique to re-establish stability of previous fixation or cement augmentation was performed in form of vertebroplasty following plate fixation. Our technique intends to prevent revision surgeries and to anchor all screws in holes which are evenly filled with bone cement.

CONCLUSIONS:
This technique of cement augmentation is a useful adjunct in those few patients where a secondary posterior surgery would be high-risk due to the general health of the patient, or when life expectancy is limited. We have shown that anterior alone reconstruction of the cervical spine with cement augmentation of screws did provide sufficient and sufficiently long stability of the cervical spine which prevented catastrophic collapse and quadriplegia in patients in poor general condition.

Klíčová slova: cement augmentation, cervical spine, corpectomy, tumor, stabilization, fusion

Zveřejněno: 1. prosinec 2017  Zobrazit citaci