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自稳型颈椎融合器在颈椎前路融合手术中的临床应用
Hits: 2646   Download times: 1537   Received:November 14, 2014    
作者Author单位UnitE-Mail
江兵 JIANG Bing 安徽医科大学附属安庆医院骨科, 安徽 安庆 246003 Department of Orthopaedics, the Affiliated Anqing Hospital of Anhui Medical University, Anqing 246003, Anhui, China jiangbing0619@163.com 
曹燕庆 CAO Yan-qing 安徽医科大学附属安庆医院骨科, 安徽 安庆 246003 Department of Orthopaedics, the Affiliated Anqing Hospital of Anhui Medical University, Anqing 246003, Anhui, China  
潘宏 PAN Hong 安徽医科大学附属安庆医院骨科, 安徽 安庆 246003 Department of Orthopaedics, the Affiliated Anqing Hospital of Anhui Medical University, Anqing 246003, Anhui, China  
朱成润 ZHU Cheng-run 安徽医科大学附属安庆医院骨科, 安徽 安庆 246003 Department of Orthopaedics, the Affiliated Anqing Hospital of Anhui Medical University, Anqing 246003, Anhui, China  
章小军 ZHANG Xiao-jun 安徽医科大学附属安庆医院骨科, 安徽 安庆 246003 Department of Orthopaedics, the Affiliated Anqing Hospital of Anhui Medical University, Anqing 246003, Anhui, China  
陶岳峰 TAO Yue-feng 安徽医科大学附属安庆医院骨科, 安徽 安庆 246003 Department of Orthopaedics, the Affiliated Anqing Hospital of Anhui Medical University, Anqing 246003, Anhui, China  
刘镇 LIU Zhen 安徽医科大学附属安庆医院骨科, 安徽 安庆 246003 Department of Orthopaedics, the Affiliated Anqing Hospital of Anhui Medical University, Anqing 246003, Anhui, China  
袁维诚 YUAN Wei-cheng 安徽医科大学附属安庆医院骨科, 安徽 安庆 246003 Department of Orthopaedics, the Affiliated Anqing Hospital of Anhui Medical University, Anqing 246003, Anhui, China  
期刊信息:《中国骨伤》2015年28卷,第4期,第294-299页
DOI:10.3969/j.issn.1003-0034.2015.04.002
基金项目:安徽医科大学基金项目(编号:2013xkj062)


目的:探讨自稳型颈椎融合器在颈椎前路融合手术中应用的临床效果。

方法:2011年1月至2014年1月,采用椎间盘切除,自体髂骨植骨自稳型颈椎融合器椎间融合术治疗颈椎疾患50例,其中男32例,女18例;年龄30~79岁,平均53.30岁;颈椎病22例,外伤性颈椎间盘突出症26例,颈椎失稳2例;单节段32例,双节段15例,3节段3例。采用日本骨科协会评定标准(Japan Orthopedic Association,JOA)对神经功能进行评估;采用Otani 分级方法对疗效进行评定;定期拍摄颈椎正侧位X线片和动力位X线片观察颈椎曲度和骨融合情况以及有无内固定相关并发症;采用Suk法评估骨融合情况。

结果:50例患者均获得随访,时间6~36个月,平均20个月。术后未见明显的手术相关并发症,均达到骨性融合,平均融合时间 4.30个月。JOA评分术后1周为16.10±2.20,术后6个月为16.40±2.35,较术前的10.60±3.00均明显提高(P<0.05).采用Otani分级方法进行疗效评定,优40例,良 9例,可1例。随访期间未出现明显的吞咽困难、融合器移位等内固定相关并发症。

结论:在颈椎前路融合手术中使用自稳型颈椎融合器疗效满意,且手术创伤小,能减少手术相关并发症的发生,是颈椎前路融合手术中一种较好的融合方法。
[关键词]:椎间盘移位  脊椎融合术  颈椎
 
Clinical application of stand-alone MC+PEEK cage in the anterior cervical fusion
Abstract:

Objective:To explore the effect of clinical application of stand-alone MC+PEEK cage in anterior cervical fusion.

Methods:From January 2011 to January 2014, 50 patients were treated with the MC+PEEK cage filled with autogenous cancellous illic-bone graft after anterior cervical discectomy. There were 22 patients with cervical spondylosis, 26 patients with traumatic cervical disc herniation, 2 patients with cervical instability in these patients. There were 32 males and 18 females, aged from 30 to 79 years old with an average of 53.30 years old. There were 32 patients with single segment, 15 patients with double segments and 3 patients with three segments. Cervical AP and lateral and the flexion-extension X-rays were regularly taken in order to assess the cervical physiological curvature, the graft fusion and internal fixation related complications. Nerve function, clinical effect and bone fusion were respectively evaluated according to Japan Orthopedic Association (JOA), Otani grade and Suk method.

Results:All patients were followed up from 6 to 36 months with an average of 20 months. No correlated surgical complications were found and all patients obtained bony fusion with an average time of 4.30 months. JOA score had significantly improvement after surgery(P<0.05). The JOA score was 10.60±3.00 before surgery and 16.10±2.20, 16.40±2.35 at one week and six months after surgery respectively. According to Otani grade, 40 cases got excellent results, 9 good, 1 fair. No significant dysphagia and internal fixation related complications such as displacement of cages were found during the follow-up period.

Conclusion:Using this cage in anterior cervical fusion can obtain satisfactory clinical effect with less operation injury and reduce the complications. It is a better fusion method in anterior cervical fusion.
KEYWORDS:Intervertebral disc displacement  Spinal fusion  Cervical vertebrae
 
引用本文,请按以下格式著录参考文献:
中文格式:江兵,曹燕庆,潘宏,朱成润,章小军,陶岳峰,刘镇,袁维诚.自稳型颈椎融合器在颈椎前路融合手术中的临床应用[J].中国骨伤,2015,28(4):294~299
英文格式:JIANG Bing,CAO Yan-qing,PAN Hong,ZHU Cheng-run,ZHANG Xiao-jun,TAO Yue-feng,LIU Zhen,YUAN Wei-cheng.Clinical application of stand-alone MC+PEEK cage in the anterior cervical fusion[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(4):294~299
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