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《Chinese Journal of Bone and Joint Injury》 2009-01
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Cause and Countermeasure in Cervical Revision Surgery

Gu Hongsheng,Li Zhenyu,Yan Hongyin,et al.Department of spine surgery,the second people's hospital of Shenzhen,Shenzhen,518035  
Objective To discuss the indications,operative methods and clinic curative effects of the cervical revision surgery.Methods Twenty-one cases of cervical vertebrae post-operation underwent cervical revision operation between April 1998 and September 2007.The time of revision from the first operation was 4 to 28 months with an average 15.3 months.All patients represented clinic symptoms,including scruff pains 16 ones,cervical motion restricted 5 times;the previous spine cord symptoms aggravated 8 ones,new spinal compression 7 ones.The preoperative diagnosis for the first time operation included:lower cervical fracture dislocation 6 cases,cervical spondylotic radiculopathy 2 cases,cervical spondylotic myelopathy 9 cases,cervical instability 4 cases.The operation style consisted of merely anterior cervical decompression plus auto-ilium graft 4 cases,anterior cervical decompression and plate fixation 8 cases,anterior cervical decompression and cage fusion 2 cases,anterior vertebrae part or total resection and internal fixation 3 cases,posterior simple CerviFix fixation 3 cases,double open door depression 1 case.Results All patients were followed up for 6 to 50 months with an average 20.4 months.The postoperative curative effects were 13 cases excellent(61.9%),6 cases good(28.6%),1 case inefficacy and 1 case aggravation.The JOA graded 2~14(8.65±0.37) preoperatively and 8~16(14.27±0.69) postoperatively.There was a significant difference(P0.01).Twenty-one cases bone graft had fusion after 6 months.There were no complication,which involved laryngeal nerve and laryngeal nerve injury,tracheo-asophageal leak,leakage of cerebrospinal fluid and respiratory system.Conclusion The cervical revision style depends on specific condition.Preoperative proper detail operation schedule,thorough decompression and correct fixation are the key to the success of the revision operation.
【CateGory Index】: R687.3
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