颈椎弓根螺钉置入固定治疗颈椎不稳的疗效和安全性分析  

Clinical results and safety analysis of pedicle screw system in surgical treatment of cervical spine instability

作　　者：胡建华[1] 仉建国[1] 田野[1] 钱军[1] 李佳忆[1] 邱贵兴[1] 

机构地区：[1]中国医学科学院北京协和医院骨科,北京100730

出　　处：《脊柱外科杂志》2008年第2期76-79,共4页Journal of Spinal Surgery

摘　　要：目的分析颈椎弓根螺钉置入固定治疗颈椎不稳的临床结果,总结其临床疗效和安全性。方法颈椎弓根螺钉固定治疗颈椎不稳19例,平均随访时间为16.3个月。分析术前及术后6个月随访时JOA评分,采用颈椎残障功能量表(neck disability index,NDI)评价患者日常生活障碍程度变化。测量术后6个月及末次随访时颈椎屈伸侧位X线片,观察融合节段的稳定性。结果术后6个月随访时JOA评分较术前增加4.2±1.3(P<0.05),平均改善率为61%。NDI评分术前为34.2±11.4,术后6个月为18.8±9.5(P<0.01),随访时融合节段稳定。椎弓根螺钉骨皮质穿破率为7.6%,未出现神经、血管损伤。结论术前仔细研究影像学资料,颈椎弓根螺钉置入固定治疗颈椎不稳可以获得满意的临床疗效和安全性。Objective Retrospectively evaluate clinical results and safety of cervical spine instability surgically treated with pedicle screw system. Methods We reviewed 19 cervical spine instability patients with an average final follow up of 16.3months. Study parameters include the JOA score and its improvement rate, NDI and segmental stability 6 months postoperation. Results JOA score improved by 4.2 ± 1.3 （P 〈 0.05） at 6 months postoperation. The mean JOA score improvement rate was 61%. NDI was 34.2 ± 11.4 preoperation, and 18.8 ± 9.5 （P 〈 0.01 ） postoperation. Upon 6 months postoperation and final follow up, fused segments were stable. Perforation rate of the pedicle wall was 7.6%. No neurovascular complications occurred. Condusion Cervical spine instability surgically treated with pedicle screw system presented safe satisfactory clinical outcomes. However, careful preoperative planning are essential in this procedure.

关 键 词：颈椎 内固定器 脊柱融合术 

分 类 号：R681.531[医药卫生—骨科学]