| 零切迹颈椎融合器在颈前路椎间盘切除植骨融合术后邻椎病翻修中的应用 |
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Received:December 15, 2023
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘铮 |
LIU Zheng |
浙江中医药大学附属江南医院 杭州市萧山区中医院脊柱外科, 浙江 杭州 311201 |
Department of Orthopaedics Surgery, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou 311201, Zhejiang, China |
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| 楼宇梁 |
LOU Yu-liang |
浙江中医药大学附属江南医院 杭州市萧山区中医院脊柱外科, 浙江 杭州 311201 |
Department of Orthopaedics Surgery, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou 311201, Zhejiang, China |
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| 费慧 |
FEI Hui |
浙江中医药大学附属江南医院 杭州市萧山区中医院脊柱外科, 浙江 杭州 311201 |
Department of Orthopaedics Surgery, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou 311201, Zhejiang, China |
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| 全仁夫 |
QUAN Ren-fu |
浙江中医药大学附属江南医院 杭州市萧山区中医院脊柱外科, 浙江 杭州 311201 |
Department of Orthopaedics Surgery, Traditional Chinese Medical Hospital of Xiaoshan, Jiangnan Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou 311201, Zhejiang, China |
quanrenf@163.com |
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| 期刊信息：《中国骨伤》2024年37卷，第11期，第1056-1061页 |
| DOI：10.12200/j.issn.1003-0034.20230543 |
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目的: 探讨零切迹颈椎Solis融合器在治疗颈前路椎间盘切除植骨融合术(anterior cervical discectomy and fusion,ACDF)术后邻椎病(adjacent segment degeneration,ASD)翻修中的早期临床疗效。
方法: 回顾性分析2017年4月至2020年12月期间,接受Solis融合器治疗的颈前路椎间盘切除植骨融合术后ASD患者13例,男5例,女8例;年龄56~78岁;患者术前均有顽固性颈部疼痛或上肢肌力浅感觉异常,保守治疗效果不佳。记录患者手术时间、术中出血量及术后并发症情况;于术前、术后1周及末次随访时采用视觉模拟评分量表(visual analogue scale,VAS)、日本骨科学会(Japanese Orthopaedic Association,JOA)评分以评估临床治疗效果;同期摄颈椎正侧位X线片及行CT检查,测量和评估椎间隙高度、椎间融合等情况。
结果: 所有患者获随访,时间18~36个月。13例患者均顺利完成翻修手术,均为单间隙。手术时间63~93 min,术中出血量15~83 ml。VAS由术前4~7分降低至术后1周1~3分及末次随访时1~2分。椎间隙高度由术前5.2~7.2 mm提升至术后1周6.4~8.0 mm,末次随访时6.4~7.9 mm。JOA评分由术前11~17分提升至术后1周13~17分、末次随访时16~17分。末次随访时颈椎正侧位X线及CT显示Solis融合器均骨性融合。术后1例出现短暂的左上肢无力,随访时恢复。所有患者无吞咽困难、切口血肿及融合器沉降。
结论: 零切迹颈椎Solis融合器在治疗ACDF术后ASD翻修中的早期临床疗效满意,具有手术创伤小、减压充分、骨融合率高及并发症少等优点,可为颈椎术后ASD的微创治疗提供新的选择。 |
| [关键词]:颈椎 退变性疾病 脊柱融合术 再手术 |
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| Application of Solis fusion device in adjacent segment degeneration revision after anterior cervical discectomy bone grafting fusion |
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Abstract:
Objective To observe the early clinical efficacy of the zero-remember cervical Solis fusion device in the treatment of adjacent segment degeneration(ASD) revision after anterior cervical discectomy and fusion(ACDF).
Methods A retrospective analysis was performed for 13 patients with adjacent spondylosis after anterior cervical discectomy bone graft fusion with Solis fusion device,including 5 males and 8 females,aging from 56 to 78 years old. The patients had intractable neck pain or superficial paresthesia of upper extremities before operation,and the effect of conservative treatment was not good. The operation time,intraoperative blood loss and postoperative complications were recorded. Before operation,1 week postoperative and final follow-up,the visual analogue scale(VAS) and Japanese Orthopaedic Association(JOA) scores were used to assess clinical efficacy. X-ray and CT of the cervical spine were performed to measure and evaluate the height of the intervertebral space and intervertebral fusion.
Results All patients were followed up from 18 to 36 months. All 13 patients successfully completed revision surgery with single gaps. The operation time was 63 to 93 min,the intraoperative blood loss was 15 to 83 ml. The pain VAS was reduced from 4 to 7 points before surgery to 1 to 3 points at 1 week and 1 to 2 points at the final follow-up. The height of the intervertebral space was increased from 5.2 to 7.2 mm before surgery to 6.4 to 8.0 mm at 1 week after surgery and 6.4 to 7.9 mm at the final follow-up. The JOA score was increased from 11 to 17 points before surgery to 13 to 17 points at 1 week after surgery and 16 to 17 points at the final follow-up visit. At the final follow-up,AP and lateral X-ray films of cervical spine showed homogeneous bone fusion of the Solis fusion. One patient developed transient left upper limb weakness after surgery,which recovered at follow-up,and all patients had no dysphagia,incision hematoma or infection,and displacement.
Conclusion The early clinical efficacy of Solis fusion device in the treatment of orthospondylosis after anterior cervical intervertebral fusion is satisfactory,and it has the advantages of less surgical trauma,adequate decompression,high osseointegration rate and fewer complications,which can provide a new option for minimally invasive treatment of orthospondylosis after cervical spine surgery. |
| KEYWORDS:Cervical spine Degenerative diseases Spinal fusion Reoperation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘铮,楼宇梁,费慧,全仁夫.零切迹颈椎融合器在颈前路椎间盘切除植骨融合术后邻椎病翻修中的应用[J].中国骨伤,2024,37(11):1056~1061 |
| 英文格式: | LIU Zheng,LOU Yu-liang,FEI Hui,QUAN Ren-fu.Application of Solis fusion device in adjacent segment degeneration revision after anterior cervical discectomy bone grafting fusion[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(11):1056~1061 |
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