珊瑚颈椎椎间融合器与钛螺纹状椎体融合器(TFC)的近期临床疗效观察  

Early results observation of the cervical interbody fusion by coralline hydroxyapatite fuser and TFC

作　　者：孟志斌[1] 付昆[1] 李洪潮[1] 李俊[1] 

机构地区：[1]海南医学院附属医院骨科,海口570102

出　　处：《颈腰痛杂志》2005年第1期7-10,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：海南医学院苗圃基金资助(基金号200216)

摘　　要：目的探索珊瑚颈椎椎间融合器与螺纹状椎体融合器(TFC)临床应用的特点和早期治疗效果,观察两种融合器植入后的颈椎的稳定性和植入节段的活动度。方法11例脊髓型颈椎病患者(17个节段)行颈前路椎体间隙减压,6例(11个节段)行珊瑚颈椎间融合器融合术,5例(7个节段)行钛螺纹状椎体融合器(TFC)融合术。手术前后采用JOA标准对颈段脊髓功能进行评分,术后1周、1月摄颈椎前后位片。观察颈椎的稳定性和植入节段的活动度。结果11例例患者均症状明显缓解、脊髓功能改善,其中优(改善率>75%)7例,良(改善率50～74%)2例.中(改善率25～49%)1例,无效(改善率<25%)0例。JOA评分由术前平均7.4分上升至术后13.4分。两组术后1周、1月置换节段稳定,没有偏移和下沉,无异常活动融合牢固。结论采用珊瑚椎间融合器及钛螺纹状椎体融合器(TFC)的椎间融合术早期均能保持颈前路减压的良好效果,同时维持了颈椎的融合稳定度。但颈椎椎间融合器是否能减少对临近节段的影响及其长期的稳定性和脊髓功能的评定尚需临床长期随访,珊瑚颈椎椎间融合术为脊髓型颈椎病的治疗提供了一种新的选择。Objective To explore the early results of coralline hydroxyapatite cervical interbody fuser and TFC in the treatment of cervical spondylotic myelopathy,and to observe the stability and segment movement after graft of two kinds of fuser. Method Eleven cases of cervical spondylotic myelopathy(17 segments)were treated by anterior decompression,6 cases(11segments)were grafted with coralline hydroxyapatite fuser and 5 cases(7 segments)with TFC. Spinal cord function in all cases were evaluated by JOA criteria before and after operation. The AP and lateral position X-ray films were taken after operation 1 and 4 weeks. The cervical stability and segment movement were investigated. Result Clinic symptoms and spinal cord function were improved apparently. Among the cases good were 7 cases(improvement>75%),fair were 2 cases improvement>50-74),middle 1 case(improvement>25-49%),and poor 0(improvement<25%). The points of JOA after operation increased from 7.4 to 13.4. Both groups were segment stable,no lateral sliding,and fusion firmly with no sinking. Conclusion Both coralline hydroxyapatite and TFC can keep good clinical result,in the sametime,can provid with stable fusion after anterior cervical decompression in early stage. Long clinic follow up is needed,for there are still unknown about the long affection to the adjacent segment,segment stability and spinal cord function after cervical fusion. Nevertheless,Coralline hydroxyapatite cervical fusion provide a new choice for the cervical spondylotic myelopathy.

关 键 词：颈椎病 椎间融合 珊瑚 TFC 

分 类 号：R689.32[医药卫生—骨科学]