頚椎前方固定術における複合型 hydroxyapatite graft の使用成績 : 146 例の使用経験から
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概要
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Object : For anterior cervical fusion, hydroxyapatite (HA) grafts have been used extensively among Japanese neurosurgeons. Many different types of HA grafts have been devised and are being marketed in Japan. However, there are still no ideal grafts. New graft : The author devised a new type of compound HA column graft which is composed of the anterior portion (40% porosity) and the posterior portion (50%). This graft is 12mm in diameter (10 and 14mm are also available), while the anterior portion is 5mm in length and the posterior portion is 15mm. The compound structure was designed to replicate the autograft's cortical bone and the cancelleus bone. The hard anterior portion is strong enough to bear stress to the intervertebral space, and the soft posterior portion is more easily unified vertebral bone. Method and results : With this new HA graft, 146 patients were operated on by following the modified Cloward's surgical method between 1994 and 2001. Post-operative follow-up observations were made by plain X-ray and CT films. Thirty patients were followed-up for more than 3 years. All of the grafts were fused firmly without pseudo-arthrosis. No destruction nor separation of the two portions of the graft were found, except for a few cracks which caused no problems. Conclusion : This operative procedure is simple and the operative results were satisfactory. The new HA graft has superior quality in strength and bone union ability. Furthermore, it can be shaped to fit the host site by cutting the posterior end. The 40%-porous HA grafts can be used safely for anterior cervical fusion.
- 日本脊髄外科学会の論文
- 2003-07-31