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논문 기본 정보

자료유형
학술저널
저자정보
장선우 (서울아산병원 신경외과) 이상협 (수원윌스기념병원) 주정균 (성모센트럴마디척의원) 신홍경 (서울아산병원) 박진훈 (서울아산병원 신경외과) 노성우 (서울아산병원 신경외과) 전상용 (서울아산병원 신경외과)
저널정보
대한척추신경외과학회 Neurospine Neurospine Vol.21 No.2
발행연도
2024.6
수록면
525 - 535 (11page)
DOI
10.14245/ns.2347132.566

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초록· 키워드

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Objective: We propose that cervical intrafacetal fusion (cIFF) using bone chip insertion into the facetal joint space additional to minimal PLF is a supplementary fusion method to conventional posterolateral fusion (PLF). Methods: Patients who underwent posterior cervical fixation accompanied by cIFF with minimal PLF or conventional PLF for cervical myelopathy from 2012 to 2023 were investigated retrospectively. Radiological parameters including Cobb angle and C2–7 sagittal vertical axis (SVA) were compared between the 2 groups. In cIFF with minimal PLF group, cIFF location and PLF location were carefully divided, and the fusion rates of each location were analyzed by computed tomography scan. Results: Among enrolled 46 patients, 31 patients were in cIFF group, 15 in PLF group. The postoperative change of Cobb angle in 1-year follow-up in cIFF with minimal PLF group and conventional PLF group were 0.1° ± 4.0° and -9.7° ± 8.4° respectively which was statistically lower in cIFF with minimal PLF group (p = 0.022). Regarding the fusion rate in cIFF with minimal PLF group in postoperative 6 months, the rates was achieved in 267 facets (98.1%) in cIFF location, and 244 facets (89.7%) in PLF location (p < 0.001). Conclusion: Postoperative sagittal alignment was more preserved in cIFF with minimal PLF group compared with conventional PLF group. Additionally, in cIFF with minimal PLF group, the bone fusion rate of cIFF location was higher than PLF location. Considering the concerns of bone chip migration onto the spinal cord and relatively low fusion rate in PLF method, applying cIFF method using minimized PLF might be a beneficial alternative for posterior cervical decompression and fixation.

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