Uncinate decompression and modified bone graft technique for anterior cervical surgery

English Keywords:Cervical spondylosis  Uncinate decompression  Mixture bone graft method  Spinal fusion

English Abstract:

  【Abstract】 Objective：The study was undertaken to compare the outcomes of uncinate decompression and modified bone graft（UDMBG） technique with routine anterior corpectomy and fusion（RACF） in anterior cervical surgery.Method：A total of 137 patients who underwent surgical treatment for 2-level cervical spondylosis from July 2008 to June 2009 were reviewed.They were divided into two groups according to the operation methods.There were 61 patients（35 men，26 women，age 41-82 years） in group A，who underwent uncinate decompressions and used allo-fibula strut filled with local auto-bone dust and local cancellous chunks of corpectomy bone placed into the decorticated uncinate regions bilaterally.There were 76 patients（47 men，29 women，age 40-78 years） in group B，who underwent RACF with iliac crest autograft.All patients were fixed with semi-rigid plates.Perioperation parameters（days of hospital stay，operation time，bleeding amount，complication rate），fuctional parameters（NDI，VAS scores），and radiologic parameters（segmental height，cervical lordosis，arthrodesis rate） were compared.Result：There were 1 C3，15 C4，26 C5，19 C6 corpectomies in group A and 1 C3，23 C4，32 C5，20 C6 corpectomies in group B.Operation time，days of hospital stay and perioperation complication rate were significantly lower in the group A（P<0.05）.There was no significant difference for the bleeding amount and the improvement of NDI and VAS between two groups.Group A has a better result for the radiculopathy and mixed cervical spondylosis.The segmental height and the Cobb angles were similar.58 cases（95.1%） fused in group A and 76 cases（100%） in group B at 1 year postoperation，without statistical difference.10 cases of hematoma and 1 case of infection after iliac bone harvest were found in group B.Conclusion：UDMBG and RACF were found to be similar in clinical outcomes and radiologic parameters.However，UDMBG decrease operative time，days of hospital stay and complication rate significantly.This modified surgical procedure applies to radiculopathy and mixed cervical spondylosis accompanied with neural foraminotomy stenosis.