Application of anterior decompression and reconstruction using titanium mesh with locking plates in the management of cervical spondylotic myelopathy

Maolin He; Zengming Xiao; Shide Li; Qianfen Chen

摘要：Objective:To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy.Methods:One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates.There were 66 men and 54 women ranges in age from 37 to 72 Years(mean age, 58.3 years).The mean Japanese orthopedic surgery association(JOA) scale was 9.6 points before operation.Patients were followed up clinically and radiographically.Results:Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml.There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture.The average follow-up period was 14.3 months(range, 12 to 24 months) in 96 who were followed up.At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improve ment of 4.8 points.The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2.No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods.Stable bone union was observed in all cases and the average time required for fusion was 5.7 months.Conclusion:Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site.When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.