Cemented vertebra and adjacent vertebra refractured in a chronic kidney disease-mineral and bone disorder patient: A case report

BACKGROUND Although percutaneous vertebral augmentation(PVA)is a commonly used procedure for treating vertebral compression fracture(VCF),the risk of vertebral refracture should be considered.Chronic kidney disease-mineral and bone disorder(CKD-MBD)is a systemic disease of mineral and bone metabolism.It is associated with an increased risk of fracture.Few studies have reported the use of PVA in patients with CKD-MBD.We herein report a rare case wherein the cemented vertebra and the adjacent vertebra refractured simultaneously in a CKD-MBD patient after PVA.CASE SUMMARY A 74-year-old man suffered from low back pain after taking a fall about 3 wk ago.According to physical examination,imaging and laboratory findings,diagnoses of T12 VCF,CKD-MBD,and chronic kidney disease stage 5 were established.He then received percutaneous vertebroplasty at T12 vertebra.Fourteen weeks later,he presented with T12 and L1 vertebral refractures caused by lumbar sprain.Once again,he was given PVA which was optimized for the refractured vertebrae.Although the short-term postoperative effect was satisfactory,he reported chronic low back pain again at the 3-month follow-up.CONCLUSION It is necessary that patients with CKD-MBD who have received PVA are aware of the adverse effects of CKD-MBD.It may increase the risk of vertebral refracture.Furthermore,the PVA surgical technique needs to be optimized according to the condition of the patient.The medium-and long-term effects of PVA remain uncertain in patients with CKD-MBD.

Research progresses of artificial intelligence in MRI of lumbar degenerative diseases

The incidence of lumbar degenerative diseases is increasing year by year,and MRI is often used in clinical diagnosis.In recent years,artificial intelligence(AI)has rapidly developed in medical field and can be used for image segmentation and auxiliary diagnosis of lumbar degenerative diseases.The research progresses of AI in MRI of lumbar degenerative diseases were reviewed in this article.

Clinical efficacy and safety of kyphoplasty for the treatment of osteoporotic vertebral compression fractures at different surgical timings based on the theory of“dynamic-static integration”

Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-static integration”.Methods:Patients with OVCF who underwent percutaneous kyphoplasty in our hospital were selected and divided into Groups A,B,and C for those undergoing surgery within 7,7—21,and>21 days of fracture occurrence.The variations in the amount of bone cement injected,pre-and post-operative pain levels,functional activity,deformity correction of the injured vertebrae,bone cement leakage,and vertebral body height loss were compared among the three groups.Results:Regarding pain relief and functional activity,the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly improved.Furthermore,the deformities of the injured vertebrae in the three groups were significantly corrected,with Groups A and B exhibiting superior correction compared to Group C.Moreover,the bone cement leakage rates in groups A and C were higher than that in Group B.At the 3-month follow-up,the loss of vertebral height in Group C was significantly higher than those in groups A and B.Conclusion:Kyphoplasty is effective for OVCF treatment.Early surgery can effectively restore the vertebral height of the injured vertebra,reduce kyphosis,and reduce height loss of the injured vertebra after surgery;nevertheless,treatment within 1—3 weeks of the fracture can reduce the occurrence of bone cement leakage,making the surgery safer.Therefore,surgical treatment within 1—3 weeks of fracture is safer and can achieve satisfactory therapeutic effects.From the perspective of traditional Chinese medicine,PKP surgery can transform the fracture end from a micromotion state to a fixed state,which fully embodies the theory of“dynamic-static integration”.

Kiran Nandivada’s Stuck Blade in a Grinder Jar Degenerative Cascade by LSTV at L5-S1

Background: Mario Bertolotti, (1917) described LSTV-Lumbar spinal transitional vertebra as Bertolotti Syndrome a century ago and associated low back pain with it. Yet, it needs to be given significance in general orthopaedic practice even now, and radiologists underreport it. LSTV is a congenital anatomical anomaly that Castellvi classified into four varying types. Purpose: I titled this phenomenon “Kiran Nandivada’s stuck blade in a grinder jar degenerative cascade by LSTV at L5-S1” to clearly explain how an abnormal mega-transverse apophysis with its various variations affects the weight-bearing mechanics as the L5-S1 which is a vital junction where the maximum body weight is directed into both the sacroiliac joints and if a transitional vertebra occurs it becomes detrimental and abnormally redirects the load-bearing forces and leads to a progressive degenerative cascade both proximally and distally. As the L5 vertebral rotations and other movements of flexion, extensions, lateral flexion are stuck like a bent grinder blade, the other areas of the region are damaged progressively as the pelvis, just like the grinder motor tries to move it, resulting in overheating and maybe even a burnout results in the form of facet arthritis, disc degeneration in the normal disc above, the transitional disc at L5-S1, foraminal osteophytes causing radiculopathy, sacroiliac joint arthritis. Material and Methods: Around 200 X-rays of children and adults with this congenital anomaly have been studied between 2020 and 2023. This is a retrospective study. Results: 1) Our study showed an Increased incidence of LSTV at 15%. 2) Patients ranged from asymptomatic, atypical lumbago to classical lumbago with sciatica and claudication. Findings supported facet and sacroiliac joint arthritis and the pain, relieved with physiotherapy, posture corrections, weight reduction, and lifestyle precautions, negating the need for local steroid injections, radiofrequency ablation or surgical excision as per our experience. Conclusion: Other dysplastic congenital manifestations like associated scoliosis, facet tropism and nerve root, and sacroiliac joint anomalies can co-exist. These radiological findings must be clearly explained to the patient so that the inherently progressive nature of this phenomenon is well understood and the patient can take the required precautions to slow them and suitable conservative treatment can be planned. In rare cases, radiofrequency ablation or even rarely a surgical resection could be beneficial, but the surgical approach could be complex as normal anatomy is changed. Hence, prior anaesthesia blocks and even scintigraphy are essential steps to clearly define and confirm the LSTV to be the actual cause of the pain.

Genome-wide association study for numbers of vertebrae in Dezhou donkey population reveals new candidate genes

Numbers of vertebrae is an important economic trait associated with body size and meat productivity in animals.However,the genetic basis of vertebrae number in donkey remains to be well understood.The aim of this study was to identify candidate genes affecting the number of thoracic(TVn)and the number of lumbar vertebrae(LVn)in Dezhou donkey.A genome-wide association study was conducted using whole genome sequence data imputed from low-coverage genome sequencing.For TVn,we identified 38 genome-wide significant and 64 suggestive SNPs,which relate to 7 genes(NLGN1,DCC,SLC26A7,TOX,WNT7A,LOC123286078,and LOC123280142).For LVn,we identified 9 genome-wide significant and 38 suggestive SNPs,which relate to 8 genes(GABBR2,FBXO4,LOC123277146,LOC123277359,BMP7,B3GAT1,EML2,and LRP5).The genes involve in the Wnt and TGF-βsignaling pathways and may play an important role in embryonic development or bone formation and could be good candidate genes for TVn and LVn.

Crossed Intralaminar Screws for Fusion of the Cervicothoracic Junction and the Thoracic Spine: The Experience in an Iberic Service with Case Series and Review of the Current Literature with Technique Description

The treatment of pathologies in the thoracic spine is a challenge. The periodic failure of pedicle screw insertion and anatomical variations make the search for an alternative to pedicle screws in thoracic spine surgery necessary. The interlaminar crossed screws is a well-known and secure method for fusion in cervical spine, and in thoracic spine there used to be insufficient clinical data to support this technique, until now. We demonstrate in an initial series of 10 cases treated with interlaminar fusion in association of other fusion techniques in the thoracic spine with good results. Objective: Intralaminar screws have been shown to be a biomechanical salvage technique in the thoracic spine, especially in long cervicothoracic, thoracic and thoracolumbar fixation. The goals of this article are to demonstrate our initial experience and the range of indications for thoracic crossed intralaminar screws. Methods: In this article we describe our initial series performed at S&#227o Teot&#243nio Hospital in Viseu, Portugal, and our results, and also provide a comprehensive review of the recent literature in the use of intralaminar crossed fixation.

喉咽颈椎旁迁徙性异物1例

1临床资料 患者,男,62岁。因怀疑颈椎横突间隙异物40 d,于2010-05-17入院。患者2个月前在食鱼后发生咽痛,剧烈咳嗽,没有咳出异物,无咳痰带血,吞咽疼痛明显,在当地医院诊断为喉咽黏膜划伤,口服抗生素治疗。近20 d来发现颈部不适,颈部转动时左侧咽部、颈部刺痛感,无声音嘶哑,间断的口服抗生素治疗。3 d前因转动颈部出现头痛症状来我院就诊入院。查体：一般情况好,心肺无异常发现,

下颈椎骨折后患者行气管切开

气管切开是建立人工气道的常用途径之一。对于下颈椎即第3～7颈椎之间的完全性脊髓损伤者有可能由于呼吸肌麻痹而造成呼吸困难,肺部痰液无法咳出,导致呼吸衰竭。应尽早行气管切开,机械辅助呼吸。但颈椎骨折后颈部固定,颈部暴露不充分，行气管切开时难度较大。我科2000年4月～2006年12月，对52例下颈椎骨折后患者行气管切开，解除呼吸道梗阻，

Treatment of large lumbar disc herniation with percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint

AIM:To evaluate the effects of percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint in the treatment of large lumbar disc herniation.METHODS:Fifty-eight patients with large lumbar disc herniation were treated with percutaneous injection of ozone via the posterior-lateral route and inner margin of the facet joint under digital subtraction angiography.Second injections were performed 5 d after the initial injection.All patients were followed up for 6-18 mo.A modified Macnab method was used for assessing clinical outcomes after oxygen-ozone therapy.RESULTS:Successful puncture was obtained in all patients.The overall efficacy was 91.4;the outcome was the excellent in 37 cases(63.8),good in 16 cases(27.6) and fair/poor in 5 cases(8.6) according to the Macnab criteria.No severe complications were found throughout this study.CONCLUSION:Percutaneous intradiscal ozone injection via the posterior-lateral route and inner margin of the facet joint is effective and safe for treatment of large lumbar disc herniation.

Treatment of Thoracolumbar Vertebrate Fracture by Transpedicular Morselized Bone Grafting in Vertebrae for Spinal Fusion and Pedicle Screw Fixation

To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A （n=20） were rein-forced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B （n=50） did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B （group A： 6.4 degree; group B： 5.4 degree）/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B （P=0.0001）. Postoperatively, greater anterior height was achieved in group A than in group B （P〈0.01）. During follow-up study, anterior vertebral height was maintained only in Group A （P〈0.001）. Both group A and group B showed good Denis pain scores （P1 and P2） but group A outdid group B in terms of control of severe and constant pain （P4 and P5）. By Frankel criteria, the changes in neurological functions in group A was better than those of group B （P〈0.001）. It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures, decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.

Bone three-dimensional microstructural features of the common osteoporotic fracture sites

Osteoporosis is a common metabolic skeletal disorder characterized by decreased bone mass and deteriorated bone structure, leading to increased susceptibility to fractures. With aging population, osteoporotic fractures are of global health and socioeconomic importance. The three-dimensional microstructural information of the common osteoporosis-related fracture sites, including vertebra, femoral neck and distal radius, is a key for fully understanding osteoporosis pathogenesis and predicting the fracture risk. Low vertebral bone mineral density(BMD) is correlated with increased fracture of the spine. Vertebral BMD decreases from cervical to lumbar spine, with the lowest BMD at the third lumbar vertebra. Trabecular bone mass of the vertebrae is much lower than that of the peripheral bone. Cancellous bone of the vertebral body has a complex heterogeneous three-dimensional microstructure, with lower bone volume in the central and anterior superior regions. Trabecular bone quality is a key element to maintain the vertebral strength. The increased fragility of osteoporotic femoral neck is attributed to low cancellous bone volume and high compact porosity. Compared with age-matched controls, increased cortical porosity is observed at the femoral neck in osteoporoticfracture patients. Distal radius demonstrates spatial inhomogeneous characteristic in cortical microstructure. The medial region of the distal radius displays the highest cortical porosity compared with the lateral, anterior and posterior regions. Bone strength of the distal radius is mainly determined by cortical porosity, which deteriorates with advancing age.

Predictive risk factors for recollapse of cemented vertebrae after percutaneous vertebroplasty: A meta-analysis

BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is considered to be an effective,safe,and minimally invasive treatment for OVCFs.The recollapse of cemented vertebrae is one of the serious complications of PVP.However,the risk factors associated with recollapse after PVP remain controversial.AIM To identify risk factors for the recollapse of cemented vertebrae after PVP in patients with OVCFs.METHODS A systematic search in EMBASE,MEDLINE,the Cochrane Library,and PubMed was conducted for relevant studies from inception until March 2020.Studies investigating risk factors for the recollapse of cemented vertebrae after PVP without additional trauma were selected for analysis.Odds ratios(ORs)or standardized mean differences with 95%confidence interval(CI)were calculated and heterogeneity was assessed by both the chi-squared test and the I-squared test.The methodological quality of the included studies was assessed according to the Newcastle-Ottawa Scale.RESULTS A total of nine case-control studies were included in our meta-analysis comprising 300 cases and 2674 controls.The significant risk factors for the recollapse of cemented vertebrae after PVP in OVCF patients were fractures located at the thoracolumbar junction(OR=2.09;95%CI:1.30 to 3.38;P=0.002),preoperative intravertebral cleft(OR=2.97;95%CI:1.93 to 4.57;P<0.00001),and solid lump distribution pattern of the cement (OR = 3.11;95%CI: 1.91 to 5.07;P < 0.00001).The analysis did not support that age, gender, lumbar bone mineral density,preoperative visual analogue scale score, injected cement volume, intradiscalcement leakage, or vertebral height restoration could increase the risk forcemented vertebra recollapse after PVP in OVCFs.CONCLUSIONThis meta-analysis suggests that thoracolumbar junction fractures, preoperativeintravertebral cleft, and solid lump cement distribution pattern are associatedwith the recollapse of cemented vertebrae after PVP in OVCF patients.

Techniques and accuracy of thoracolumbar pedicle screw placement

Pedicle screw instrumentation has been used to stabilize the thoracolumbar spine for several decades. Although pedicle screws were originally placed via a freehand technique, there has been a movement in favor of pedicle screw placement with the aid of imaging. Such assistive techniques include fluoroscopy guidance and stereotactic navigation. Imaging has the benefit of increased visualization of a pedicle's trajectory, but can result in increased morbidity associated with radiation exposure, increased time expenditure, and possible workflow interruption. Many institutions have reported high accuracies with each of these three core techniques. However, due to differing definitions of accuracy and varying radiographic analyses, it is extremely difficult to compare studies side-by-side to determine which techniques are superior. From the literature, it can be concluded that pedicles of vertebrae within the mid-thoracic spine and vertebrae that have altered morphology due to scoliosis or other deformities are the most difficult to cannulate. Thus, spine surgeons would benefit the most from using assistive technologies in these circumstances. All other pedicles in thethoracolumbar spine should theoretically be cannulated with ease via a free-hand technique, given appropriate training and experience. Despite these global recommendations, appropriate techniques must be chosen at the surgeon's discretion. Such determinations should be based on the surgeon's experience and the specific pathology that will be treated.

腰部的脊骨的磁性的回声成像上的过渡 lumbosacral 解剖的预言

AIM:To evaluate two simple angle measurements for predicting lumbosacral transitional vertebra(LSTV) in magnetic resonance imaging(MRI) studies of the spine.METHODS:The lumbar spine MRI studies of 50 subjects with LSTV and 50 subjects with normal lumbosacral anatomy were retrospectively evaluated.In each study,the mid-sagittal T2-weighted image was used to measure the angle formed by a line parallel to the superior surface of the sacrum and a line perpendicular to the axis of the scan table(A-angle),as well as the angle formed by a line parallel to the superior endplate of the L3 vertebra and a line parallel to the superior surface of the sacrum(B-angle).RESULTS:The total study population consisted of 100 subjects(46 males,54 females,51 ± 16 years old).There were no differences in age and sex between the two groups.Both A-angle and B-angle were significantly increased in subjects with LSTV compared to controls(P 【 0.05).The optimal cut-off values of A-angle and B-angle for the prediction of LSTV were 39.8°(sensitivity = 80%,specificity = 80%,accuracy = 83%;95% confidence interval = 74%-89%,P = 0.0001) and 35.9°(sensitivity = 80%,specificity = 54%,accuracy = 69%;95% confidence interval = 59%-78%,P = 0.0005),respectively.CONCLUSION:On sagittal MR images of the lumbar spine,an increased A-angle and/or B-angle should alert the radiologist to the presence of LSTV.

Quantitative trait loci for the number of vertebrae on Sus scrofa chromosomes 1 and 7 independently influence the numbers of thoracic and lumbar vertebrae in pigs

Although quantitative trait loci（QTLs） for number of thoracic-lumbar vertebrae have been identified on Sus scrofa chromosomes（SSCs） 1 and 7, the influence of these QTLs on the thoracic and lumbar vertebrae is not clear. The aim of this study was to identify single nucleotide polymorphisms（SNPs） associated with total number of thoracic-lumbar vertebrae and for each trait（number of thoracic and lumbar vertebrae） separately. A total of 581 individuals from an F2 Large White×Minzhu population were genotyped using an SNP60 K chip. Performing a genome-wide association study（GWAS） for total number of thoracic-lumbar vertebrae, 38 significant SNPs were identified in two QTL regions located on SSC1 and SSC7. Performing a GWAS for number of thoracic vertebrae only, 72 significant SNPs were located on SSC7. While performing a GWAS for number of lumbar vertebrae only, 17 significant SNPs were identified on SSC1. Gene mining suggested that the gene encoding orphan nuclear receptor, germ cell nuclear factor（NR6A1） on SSC1 was a strong candidate affecting the number of lumbar vertebrae in pigs. Additionally, genes encoding vertnin（VRTN）, prospero homeobox 2（PROX2）, Finkel-Biskis-Jinkins murine osteosarcoma viral oncogene homolog（FOS）, and transforming growth factor beta 3（TGFB3） may be important candidates affecting the number of thoracic vertebrae in pigs. QTLs on SSC1 and SSC7 independently influenced the numbers of thoracic and lumbar vertebrae. These results shed light on the complex genetic background of vertebrae development in pigs.

A Variant Maneuver of Acupuncture in Treating Cervical Spondylopathy

Lifting and thrusting with reducing method at acupoint Huatuojiaji (Extra 21) of the affected side was performed to make the limb of the affected side contract involuntarily 1-2 times in 53 cases with cervical spondylopathy. The maneuver produced a much better total effective rate than the routine maneuver (P<0.01).The instant and long-term analgesic effects were also found superior (P<0.01). Probably this is due to the increased serum content of morphine-like substance.

A Clinical Study on the Effect of Yinxing Damo (银杏达莫) Combined with Betahistine Hydrochloride Injection on Vertebral Basilar Artery Ischemic Vertigo

To evaluate the therapeutic efficacy of Yinxing Damo （银杏达莫, YXDM） combined with Betahistine Hydrochloride Injection （BHI） on vertebra basilar artery ischemic vertigo （VBIV）. Methods： Ninety patients with VBIV were randomly divided into two groups; 45 patients （the treated group） were treated with YXDM and BHI intravenous dripping, once a day for 14 days. Another 45 patients （control group） were treated with Xueshuantong （血栓通） and BHI intravenous dripping, once daily for 14 days. The clinical syndromes and the index of the transcranial Doppler （TCD） and hemorheology were observed. Results： The total effective rate was 100% in the treated group, which was better than that in the control group 90.5%, （P〈0. 05）. The indexes of TCD and hemorheology in the treated group were obviously improved after treatment, （P〈0.01）. Conclusion： YXDM combined with BHT injection had better effect in treating patients with VBIV is an ideal drug for VBIV.

Characteristics of Rat Lumbar Vertebral Body Bone Mineral Density and Differential Segmental Responses to Sex Hormone Deficiency:a Clinical Multidetector Computed Tomography Study

Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline bone mineral density （BMD） characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography. Results Para-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery. Conclusion The approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.

3D Shape Reconstruction of Lumbar Vertebra From Two X-ray Images and a CT Model

Structure reconstruction of 3 D anatomy from biplanar X-ray images is a challenging topic. Traditionally, the elastic-model-based method was used to reconstruct 3 D shapes by deforming the control points on the elastic mesh. However, the reconstructed shape is not smooth because the limited control points are only distributed on the edge of the elastic mesh.Alternatively, statistical-model-based methods, which include shape-model-based and intensity-model-based methods, are introduced due to their smooth reconstruction. However, both suffer from limitations. With the shape-model-based method, only the boundary profile is considered, leading to the loss of valid intensity information. For the intensity-based-method, the computation speed is slow because it needs to calculate the intensity distribution in each iteration. To address these issues, we propose a new reconstruction method using X-ray images and a specimen’s CT data. Specifically, the CT data provides both the shape mesh and the intensity model of the vertebra. Intensity model is used to generate the deformation field from X-ray images, while the shape model is used to generate the patient specific model by applying the calculated deformation field.Experiments on the public synthetic dataset and clinical dataset show that the average reconstruction errors are 1.1 mm and1.2 mm, separately. The average reconstruction time is 3 minutes.

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

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 improvement 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.