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Cervical spondylotic myelopathy (Cervical Spondylotic Myelopathy, CSM) is generally considered to be due to cervical disc degeneration, disc space height loss, secondary segmental instability, caused by hyperplasia of the vertebral body and intervertebral joints, resulting in compression of spinal cord and / or spinal cord The blood supply and cause disorders associated with spinal cord function. The onset of the disease are more hidden, different duration of disease, clinical manifestations, early diagnosis and treatment is not timely, differences can significantly affect the treatment and prognosis. CSM showed a progressive increase trend, resulting in physical disability likely. Most doctors believe Once identified, in addition to the small number of cases outside the conservative treatment is feasible, and more should be earlier underwent surgery. Most clinical reports suggest that decompression, reconstruction of a stable surgical treatment, the recovery of spinal cord function is quite satisfactory. Anterior cervical decompression and fusion because of its complete decompression, the physiological function of the cervical spine, and has become one of the main surgical treatment of cervical spine injuries. In addition to the traditional implantation of autologous iliac in recent years, a variety of interface within fixed in anterior cervical fusion applications, titanium surgical mesh (Titanium SurgicalMesh, TSM, hereinafter referred to as \species. This retrospective summary of our hospital from January 2004 to March 2008, using two implants of titanium mesh and autologous iliac bone after anterior cervical decompression and fusion treatment of 65 cases of cervical spondylotic myelopathy and comparative analysis of the use of two fixed- matter when intraoperative situation, postoperative complications, imaging data, and nerve function improvement. Inclusion criteria and exclusion criteria to establish screening cases, 65 cases to meet the requirements of the case, in accordance with the different surgical methods are divided into Group A titanium mesh implantation combined with AO plate fixation B group autologous iliac joint implantation AO plate fixation. After a mean follow-up of 14.1 months (12 to 18 months). The two groups were statistically analyzed in terms of intraoperative and postoperative complications, imaging data and neurological function improvement. Intraoperative blood loss and operative time to evaluate; postoperative complications, including neck, iliac fixation complications; 1 week after surgery, respectively, in March, June and 1 year after the camera X ray measurements including the integration of the curvature, height and fusion rate; neurological improvement use the JOA to improve rate evaluation. The results showed: ① A the group titanium mesh group operative time and the amount of bleeding were 80.0 ± 13.0min, 65.4 ± 10.1 ml, lower than in group B with autologous iliac 94.8 ± 9.6 min, 78.3 ± 12.3 ml, statistically significant differences (the P <0.01); ② titanium mesh after group 1 cases steel mild lateral displacement occurred, three cases of screw loosening autogenous iliac group one cases of steel plate mild sway. The postoperative neck no significant complications. Autogenous iliac group for bone pain and infection complication rate was 10.3%. Two sets of surgical complication rate is higher than autogenous iliac group titanium mesh group, but there were no significant difference (P> 0.05); ③ fusion segmental lordosis Cobb angle in one week after the two groups compared with preoperative a significant improvement (P> 0.05). Relative to March after after 1 week and 1 year postoperatively relative decline for 3 months after the titanium mesh group lordosis Cobb angle than the self small group of iliac, titanium mesh group decreased by 0.08 ° ± 0.84 ° 0.04 ° ± 0.68 °, autogenous iliac group 0.81 ° ± 0.64 ° 0.51 ° ± 0.67 °, the difference between the two groups was statistically significant (P <0.01); ④ two groups the leading edge of the fusion segment is highly the HAB consistent (P> 0.05 ), but the titanium mesh postoperative March relative to one week after surgery, the degree of decline after 1 year relative to 3 months after the rear edge height HPB than autogenous iliac block group light, titanium mesh group decreased 0.21 ± 0.34mm, 0.12 ± 0.26mm, autologous iliac bone group, 1.46 ± 0.49mm, 0.72 ± 0.38mm, the difference between the two groups with statistical significance (P <0.01); ⑤ patients with abnormal JOA score significantly improve different periods the JOA to improve the rate of no difference (P> 0.05). The results proved that the titanium mesh group in maintaining postoperative fusion segment curvature and height superior to autologous iliac bone group, cervical posterior the the edge height HPB loss increases anterior column tension more prone to screw loosening concurrent disease, thereby affecting fusion rate. Autogenous iliac block group because of the increase taking bone for bone area, making the operative time, increased the amount of bleeding, and may cause long-term pain for bone area. Titanium mesh implantation with autologous iliac bone implantation are the anterior decompression treatment CSM's important and effective method, but the titanium mesh implantation reduce surgical trauma, and better maintain the fusion segment vertebral while trailing edge height and lordosis, can obtain the same clinical effect, is an ideal technique for the treatment of the CSM.
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