경척추 질환에서 전방잠금일측치밀골 고정장치를 이용한 경척추 내고정술의 예후인자
Prognostic Factors of Locking Unicortical System in Internal Fixation for Cervical Spine Lesions
소속 상세정보
최광식/Gwang Shik Choi
배장호/우병길/김성호/김오룡/최병연/조수호/Jang Ho Bae/Byung Kil Woo/Seong Ho Kim/Oh Lyong Kim/Byung Yon Choi/Soo Ho Cho
KMID : 0359819990280040452
Abstract
결론
1) 두 경추 전방잠금일측치밀골 고정기구를 이용한 기구 고정에서 자가골이식이나 동종골
이식의 구분없이 높은 골 유합율을 보였고 공여 부위의 동통이 우려되는 자가골 이식을 피
하고, 동종 골이식을 시행한 후 경추 전방잠금일측치밀골 고정기구를 이용한 기구고정도 좋
은 수술의 하나로 생각된다.
2) Orion plate system이 Morscher plate system보다 한 분절 응합술시 수술적 조작이 쉬
워 수술시간이 적게 걸렸다.
3) Morscher plate system에서 1예의 금속판 골절이 발생한 것으로 보아 Orion plate
system이 더 튼튼한 것으로 생각되어진다.
#초록#
Although anterior cervical plate provide excellent fixation for anterior column, the
potential risk for injury to spinal cord or soft tissue has been the reason why they have
not gained universal acceptance. For this reason, anterior cervical locking plating
systems were designed to avoid such surgical complications.
The authors reviewed 98 patients who underwent anterior cervical fusion with anterior
cervical locking unicortical system during the period of January 1995 to December 1997.
Mean follow up period was 8.4 months. Morscher plate placement was done in 24 and
Orion plate was applied in 74. We compare the safety and efficacy of these tow plates.
The two groups were comparable in demographic details. mean ass(Morscher 41, Orion
47) average fusion level(Morscher 1.25, Orion 1.55) and fusion rate(Morscher 95.8%,
Orion 100%).
For comparison of hardware eclated complication, two patients(2.7%) showed screw
loosening without need for reoperation in Orion plate group. In Morscher plato group, 1
patient(4.l%) developed plate fracture and 1 patient(4.l%) developed screw loosening. but
did not require delete(re) operation. Non-hardware related complications in Morscher
group were seen in 2 patients(8.2%): one delete CSF leakage and the other being
postoperative hematoma collection. In Orion plate group, complications were developed in
9 patients(12%) : two nerve injuries(recurrent laryngeal and hypoglossal nerve), two
CSF leakages, two wound infections. one postoperative hematoma collection, two donor
graft site pains. Reoperations were dons in two cases(2%) due to two postoperative
hematoma collection one in Morscher plate group and one in Orion plats group.
In one level fusion, longer operation time was required in Morscher plate group(2.17±
93.7min) compared to Orion plate group(157±47min)(p<0.05). In this study two types of
anterior cervical locking plats and screw system had good bony fusion and cervical
stabilization with few instrument related complication. Moreover, allograft bony fusion
with anterior cervical locking plats and screw system had good solid bony fusion
without donor site morbidity. Instrument related complications were more common in
Morscher locking plats and screw system.
Anterior cervical locking unicortical system; Morscher plate system; Orion plate system; Bony fusion; Hard ware complications;
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