钛质外科网和自体髂骨块在颈椎前路减压融合术中应用的对比性研究  

A radiographic comparison between the iliac bone autograft and the titanium surgical mesh in anterior cervical decompression and fusion

作　　者：吕碧涛[1] 袁文[1] 王新伟[1] 张竞[1] 徐蕾[2] 

机构地区：[1]第二军医大学附属长征医院骨科,上海市200003 [2]第二军医大学卫勤系统计学教研室,上海市200433

出　　处：《中国脊柱脊髓杂志》2004年第7期399-402,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:比较钛质外科网(简称'钛网')与自体髂骨块在颈椎前路减压融合术中恢复、维持颈椎曲度及椎间高度上的差异.方法:对59例确诊为脊髓型颈椎病的患者行颈椎前路减压融合术,其中22例行钛网植骨加AO纯钛带锁钢板内固定,37例行自体髂骨块植入加AO纯钛带锁钢板内固定.分别摄术前、术后即刻、术后随访时的颈椎标准侧位X线片,以Cobb角测量融合节段的前凸(或后凸),以D值评价颈椎的前凸(或后凸),同时测量融合节段椎体前缘高度(HAB)、后缘高度(HPB).对各参数不同时期间差值分别行组间配对t检验.结果:经9～18个月随访(平均10.8个月),所有病例均获骨性融合.术后3个月钛网组及自体髂骨块组融合节段后高(HPB)和前凸Cobb角相对于术后即刻变化有显著性差异(P＜0.01);术后6个月钛网组及自体髂骨块组融合节段后高(HPB)和前凸Cobb角相对于术后3个月变化有显著性关(P＜0.01).但两组的D值无显著性差异.结论:在维持融合节段椎体后缘高度和前凸上钛网优于自体髂骨块,但在维持颈椎曲度上无显著性差异.Objective:To study the difference in restoring lordosis and interverberal height between the iliac bone autograft and the titanium surgical mesh in anterior cervical decompression and fusion(ACDF). Method: 59 cases of cervical spondylotic myelopathy(CSM) treated with anterior decompression,reconstruction and AO titanium locking plates fixation were included,22 with titanium surgical mesh,37 with iliac bone autograft.Preoperative,immediate postoperative and 9~18 months follow-up radiographs were taken,lordosis(kyphosis) of the fusion segment with Cobb’s angle,lordosis(kyphosis) of cervical spine with D numerical value and interverberal height were measured,and the data was compared statistically with student’s t-test.Result:Fusion were reached in all cases during the mean follow-up 10.8 months(9~18months). But there were significant differences on interverberal posterior height loss and restoring lordosis of fusion segment at different time interval(P<0.01).Conclusion:Titanium surgical mesh is better than iliac bone autograft in restoring interverberal posterior height and lordotsis of fusion segment.

关 键 词：颈椎病 钛质外科网 自体髂骨块 X线片 

分 类 号：R687.3[医药卫生—骨科学] R681.5[医药卫生—外科学]