Allogenicversusautologous bone filled cages for cervical spondylotic myelopathy

Sun Jia-jia; Yang Hui-lin; Zhou Jun; Zhang Bin; Zhang Kai

doi:10.3969/j.issn.2095-4344

Abstract：BACKGROUND:There are many filing materials used in anterior cervical fusion. Autogenous bone and alograft bone account for a large proportion; however, autogenous bone induces many complications such as hemorrhage, infection and postoperative pain in the donor bone region, which has been attracted attentions gradualy. Alogeneic bone with good biocompatibility and safety can be used as a kind of ideal fusion filing material. <br> OBJECTIVE:To compare the clinical efficacy of autogenous bone or alograft bone filed cage combined with steel plate in the anterior cervical fusion. <br> METHODS:A total of 44 patients (44 segments) with cervical spondylotic myelopathy underwent anterior cervical discectomy, interbody fusion combined with steel plate fixation from January 2012 to June 2013. An oblique anterior cervical incision, 2.5-3.0 cm, was made. The intervertebral disc and posterior longitudinal ligament were cut and the endplate was tried to be reserved. Then, the iliac bone from 24 cases was obtained for the interbody fusion, and alogeneic bone was used in 20 cases. Clinical efficacy was assessed with X-ray, Japanese Orthopaedic Association (JOA) grade and Odom’s evaluation scale. <br> RESULTS AND CONCLUSION:Al patients acquired the folow-up of 12-18 months, and there were no significant differences between the two groups in the postoperative complications and JOA score. The excelent and good rate (Odom’s standard) was significantly higher in the alogeneic bone group than the autogenous bone group (P < 0.05). After 3 and 6 months, the fusion rates in the alogeneic bone group were lower than those in the autogenous bone group, and the fusion rates of two groups were 100% after 12 months. Imaging studies revealed that at 3, 6, 12 months after operation, there were no differences between the two groups in the intervertebral height and Cobb’s angle (P > 0.05). These findings indicate that alogeneic bone has a fusion rate similar to the autogenous iliac bone in the treatment of cervical spondylotic myelopathy, and it also can maintain the cervical physiological curvature and help to restore the intervertebral height, which is considered as an ideal bone filing material for anterior cervical fusion.