ボックス型ケージを使用した頚椎前方固定術とSmith-Robinson法の手術成績の比較検討

A Retrospective Comparison between Anterior Cervical Interbody Fusion with the Use of a Rectangular Titanium Cage and by the Smith-Robinson Procedure

　当院では頚椎前方固定術においてボックス型チタンケージを使用しており，その有用性を検討したので報告する．対象はSmith-Robinson法（SR群）11例，ボックス型ケージ（BC群）11例である．JOAスコア改善率に有意差は認めず，手術時間，出血量はBC群が136.1分，42.7mlで有意に少なかった（p＝0.037，p＝0.048）．局所前弯角の変化，固定椎体間高の変化には有意差は認められなかったが，最終観察時の局所前弯角はBC群が有意（p＝0.009）に良好な矯正が保持されていた．ボックス型ケージはSmith-Robinson法に比較して，局所前弯角の獲得と維持に優れている術式であると考えられた．

　We retrospectively investigated the usefulness of the rectangular-design titanium cage for anterior cervical interbody fusion by comparing a group of 11 patients in which a rectangular titanium cage was used (BC group) and a group of 11 patients in which the Smith-Robinson procedure was used (SR group). There was no significant difference in postoperative JOA score between the groups. Operation time was significantly shorter (mean 136.1 min, and blood loss was significantly less 42.7 ml) in the BC group. At the final follow-up examination (p＝0.009), segmental lordosis was significantly better in the BC group but there was no significant difference in the correction loss of the segmental lordosis or vertebral height. This study shows that the surgical procedure using the rectangular-design titanium cage is more effective in correcting segmental lordosis than the Smith-Robinson procedure.