Anterior cervical decompression and bone graft fusion

Cervical spondylosis surgery can be divided into anterior cervical approach, lateral anterior decompression and posterior laminectomy, semi-laminar resection and laminectomy. Treatment of diseases: vertebral artery type cervical spondylosis Indication Cervical anterior decompression and bone graft fusion is applicable to: 1. Mixed cervical spondylosis, both spinal cord and nerve root coexist. 2. Cervical spondylosis of nerve root type and vertebral artery type, which is diagnosed by imaging examination. Contraindications 1. The diagnosis is not clear, the symptoms and signs are blurred, or the diagnostic evidence is insufficient; the segment of the lesion is not clear. 2. The patient's general condition is poor, accompanied by patients with important organ diseases. Surgical procedure Incision Select the lesion side, such as uniform lesions on both sides, select the severe side, make a transverse incision of the neck, reveal the vertebral body and intervertebral disc. 2. Long neck muscle treatment The longitudinal muscles of the longitudinal muscles in front of the transverse vertebral body of the cervical vertebrae are symmetrical. When determining the surgical site, first use the finger to touch the anterior vertebral nodules on the outside of the long neck muscle and use this as a boundary marker. Use the stripper to peel the longus muscle from the lateral anterior and the paravertebral vertebral body from the outside to the inside, and place it under the longissimus dorsi muscle. Into a curved vascular clamp, through the ligation and cut, the suture is not cut off for traction. The cervical long muscles will be cut off and then separated up and down to reveal a transverse process above and below the intervertebral disc. The hook joints on the lesion side are also exposed. 3. Intervertebral disc ring saw drilling In the proposed drilling disc, the drill core is drilled, the ring saw is used to drill, and the intervertebral disc and the adjacent vertebral body part of the bone are removed to reach the posterior longitudinal ligament. If the posterior margin of the vertebral body has osteophytes, it can also be scraped off at the same time. 4. Hook joint resection and intervertebral foratomy The fibrous tissue on the outside of the hook joint was carefully peeled off, and the stripper was placed on the outside to protect it. Insert the long-mouthed rongeur, one page into the borehole, one page of the hook joint, and the front part of the hook joint. The remaining part, the front and the inner side of the intervertebral foramen, are carefully scraped off with a small curette. It can also be bitten open with a long handle ultra-thin impact rongeur. 5. Interbody fusion The autogenous iliac bone graft is implanted into the intervertebral space bore. complication 1. Major bleeding is the most serious and most dangerous complication. When the hook joint is removed and the intervertebral foramen is cut, the root arteriovenous hemorrhage is caused by pulling or adhesion. Hemorrhagic shock is prone to occur if no measures are taken. Local clamps are not easy to be successful due to stenosis, and can be filled with gelatin sponge to stop bleeding. The vertebral artery is thicker, the pulsation is obvious, and there is less chance of injury during the operation, unless the operation field is unclear, and the force is too strong to cause tearing. Once bleeding will be life threatening. 2. Positioning error, causing surgery failure. Therefore, the importance of preoperative and intraoperative positioning must be emphasized.