Anatomical Morphology And Clinical Study Of Cervical Laminae As Bone Graft In Anterior Cervical Discectomy And Fusion

Objective1.To investigate the feasibility of using autologous cervical laminae as bone graft in anterior cervical discectomy and fusion during one-staged posterior-anterior cervical surgery.2.To describe the clinical and radiographic outcomes in patients undergoing combined postero-anterior cervical surgery using autologous laminae as bone graft in ACDF.Methods1.60 CT scans and sagittal reconstruction images of the cervical spine were harvested,including 30 males and 30 females,aged from 25 to 40 years old.The length of the line which connects the bilateral intersection points of cervical laminae and pedicle,and the distance from the junction of bilateral lamina to the line which was mentioned above were measured.Then,the area of the triangle composed by the bilateral laminae from C3 to C7 was calculated and compared with the area of a commonly used PEEK cage.The heights of the laminae from C3 to C7 were measured and compared with the corresponding intervertebral space heights.2.Between January 2010 and June 2014,15 patients with cervical spinal stenosis underwent surgical treatment in our hospital.All of them underwent one-stage postero-anterior cervical surgery using the antologous cervical laminae as bone graft in ACDF.The clinical data and imaging materials were analyzed retrospectively.Results1.The area of the triangle composed by the bilateral laminae from C3 to C7 was greater than that of the PEEK cage.The heights of the laminae from C3 to C7 were greater than those of corresponding intervertebral.2.Results: The opertation time of the patients was 102.7±13.9 min.The intraoperation blood loss of them was 170.3±25.7 ml.All patients were followed up from 6 months to 42 months(mean,16.5months).At final follow-up,the fusion rate of bone graft was 100%.postoperativly,the excellent and good results were reported in 80 % according to Odom,scriteria.The average preoperative and postoperative lordosis angles of the cervical spine had significant difference(P?0.05),Little loss of the the angle was noted at final follow-up(P?0.05).Anterior intervertebral space height was significantly increased((P?0.05))after the surgery and a little declined at final follow-up(P?0.05).Conclusion1.Basing on the anatomical measurement of the cervical spine,using the autologous cervical laminae as bone graft in anterior cervical discectomy and fusion is feasible.2.Structural autograft harvested from the laminae as bone substitute acquired great of achievementsin anterior cervical discectomy and fusion,it can serve as a choice for the bone substitute in clinical.