颈椎前路钢板置入在脊髓型颈椎病术后脊柱生理曲度恢复中的作用:1年结局随访(英文)  

Influence of cervical anterior plate on restoring physiological curvature of cervical vertebra after cervical spondylotic myelopathy:A one-year outcome follow-up

作　　者：高志增[1] 曹凯[1] 张志宏[1] 舒勇[1] 韩智敏[1] 

机构地区：[1]南昌大学第一附属医院骨科,江西省南昌市330006

出　　处：《中国组织工程研究与临床康复》2007年第45期9213-9216,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：江西省卫生厅科技项目(033001)~~

摘　　要：背景:维持良好的颈椎曲度亦是改善脊髓型颈椎病患者神经症状的重要前提,已有研究证实骨科前路钢板内固定植入物置入对维持颈椎生理曲度具有良好的作用。目的:评价颈椎前路钢板植入物置入术后脊髓型颈椎病患者颈椎生理前凸的恢复情况。设计:观察实验。单位:南昌大学第一附属医院。对象:选择2003-02/2006-01在南昌大学第一附属医院骨科72例确诊为脊髓型颈椎病患者,男46例,女26例;年龄45～70岁,平均54岁;病史2～6年。纳入标准:①MRI显示颈脊髓受压。②均取自体髂骨植骨。实验经过医院伦理委员会批准许可,所有患者均对检测项目知情同意。所有颈椎前路钢板为枢法模公司生产提供的Orion锁定钢板。根据手术需要分为单节段椎间盘切除组(n=32)及两节段椎间盘切除组(n=40)。方法:①采用经前路减压+自体髂骨植骨+钛质钢板内固定置入法,患者取仰卧位,肩背部垫高,颈后仰,气管内插管全麻。取颈前右侧横行或斜型切口,在Caspar椎体牵开器辅助下行椎间盘切除减压,取自体3面皮质髂骨植入减压椎间隙,安装Orion带锁钛板,获即刻稳定,放置引流,缝合切口。②术后颈托保护下进行日常活动,8周后逐步去除颈托。③分别于手术前、术后即刻、术后6及12个月颈椎标准侧位X线片,以Cobb角测量融合节段的前凸,以D值评价颈椎的前凸,对数据进行统计分析。④术后12个月随访观察患者骨性融合情况。椎间融合标准为:融合节段间两棘突尖之间无异常活动,植骨块与上下椎体界面间无透亮带,其骨小梁通过植骨块与椎体界面。⑤随访中材料与宿主的生物相容性反应。主要观察指标:①患者手术前后不同时间点Cobb角、D值的变化。②随访骨性融合及排斥情况。结果:纳入患者72例均进入结果分析。①单节段椎间盘切除组及两节段椎间盘切除组患者术后即刻,术后6及12个月Cobb角�BACKGROUND ： It is necessary to keep a good cervical curvature for improving nerve symptom in patients with cervical spondylotic myelopathy （CSM）. It is verified that cervical anterior plate internal fixation implant is effective to restore the physiological curvature of cervical vertebra. OB]ECTrVE： To assess the physiological lordosis of cervical vertebra in CSM patients after cervical anterior plate internal fixation implantation. DESIGN ： Observational study SETTING ：. First Affiliated Hospital of Nanchang University PARTICIPANTS： Totally 72 CSM patients were enrolled at Department of Orthopaedics, First Affiliated Hospital, Nanchang University from February 2003 to January 2006, including 46 males and 26 females, aged 45-70 years, averagely 54 years, with the history of 2-6 years. Inclusive criteria included ①cervical spinal cord compression shown in MRI, and ②using autogenous lilac bone. The experiment was approved by Hospital Ethics Committee, and all patients signed the informed consent. Cervical anterior plate was Orion locking plate offered by Shufamo Company. There were single segmental discectomy group （n =32） and two-level segmental discectomy group （n =40） according to experimental requirement. METHODS ：①Anterior decompression plus autogenous lilac bone implant plus titanium plate internal fixation were utilized. The patients were in supine position; shoulder and back were blocked up; neck backward, and endotracheal tube was done under general anesthesia. Transverse or oblique incision was made at right anterior neck. Discectomy decompression was performed with Caspar vertebra ecarteur. Three-dimensional autogenous lilac bone was implanted in decompressed intervertebral space. Immediate stability was obtained after Orion locking titanium plate was fixed, with placement drainage, and then the incision was sutured. ②Postoperative daily activities were conducted with cervical gear, which was removed 8 weeks later. ③Lateral cervical vertebrae X-rays were taken b

关 键 词：前路钢板 颈前路椎间盘切除椎间融合术 脊髓型颈椎病 生理性前凸 骨科植入物 

分 类 号：R681.531[医药卫生—骨科学]