钛网联合Cage配合自锁钛板治疗多节段颈椎间盘突出症  

TREATMENT OF MULTILEVEL CERVICAL INTERVERTEBRAL DISC PROTRUSION USING TITANIUM MESH CAGE WITH SELF-LOCKED TITANIUM PLATE

作　　者：姜永庆[1] 张挺[1] 董大明[1] 王岩松[1] 刘庆鹏[1] 

机构地区：[1]哈尔滨医科大学附属二院脊柱外科,哈尔滨150086

出　　处：《中国修复重建外科杂志》2008年第8期897-900,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结钛网联合Cage配合自锁钛板在多节段颈椎间盘突出症前路椎间盘切除后椎体间融合的效果。方法回顾性分析2004年9月-2007年6月采用钛网联合Cage配合自锁钛板治疗18例多节段颈椎间盘突出症的临床效果。男11例,女7例;年龄32～75岁,平均54岁。病程6个月～15年,平均5.8年。肢体感觉障碍16例;四肢肌力2级3例,3级12例,4级1例,5级2例;锥体束征阳性16例;大小便障碍13例;性功能障碍8例;伴神经根型症状7例。其中连续的多节段12例,不连续的多节段6例。术前JOA评分为(8.30±1.21)分。X线片及MRI示不同程度椎间盘退变、突出、颈髓受压。术前X线片测得病变椎间隙高度为(6.40±0.87)mm。结果术后切口均Ⅰ期愈合。患者均获随访,随访时间6～36个月,平均18个月。术后早期四肢运动功能恢复较好,感觉障碍恢复较慢;术前肌张力高者术后肌张力下降;患者肢体灵活性改善。手术椎间隙于术后3～6个月获骨性融合,未见塌陷。术后6个月,JOA评分为(12.60±0.78)分,改善率51.8%,与术前比较差异有统计学意义(P<0.05);病变椎间隙高度为(8.20±0.46)mm,与术前比较差异有统计学意义(P<0.05)。按照Odom临床效果分级进行评价,优17例,良1例。无死亡,无脊髓、神经、气管及食道损伤等并发症发生,无Cage移位及松动发生。结论对于多节段颈椎间盘突出症,钛网联合Cage配合自锁钛板固定更具优势。Objective To observe the effect of titanium mesh cage with self-locked titanium plate on the cervical inter-body fusion after anterior discectomy of multilevel cervical intervertebral disc protrusion. Methods The therapeutic effect of 18 patients who received the treatment of titanium mesh cage with self-locked titanium plate from September 2004 to June 2007 were retrospectively analyzed, including 11 males and 7 females （aged 32-75 years, 54 years on average）. The course of dlsease was 6 months to 15 years （5.8 years on average）. Sixteen patients suffered sensory dysfunction in limbs. Concerning the muscle strengthof extremities, 3 cases were on the second level, 12 were on the third level, 1 was on the fourth level, and 2 were on the fifth level. Sixteen cases had pyramidal sign, 13 had retention of urine and feces, 8 had sexual dysfunction, and 7 combined with symptoms of nerve root type. Twelve cases were consecutive multilevel and 6 cases were discontinuous multilevel. The mean JOA scores were 8.30 ± 1.21 preoperatively. X-ray films and MRI showed degeneration and protrusion of intervertebral disc and compression of cervical cord preoperatively. The height of involved intervertebral space was （6.40 ±0.87） mm on X-ray films preoperatively. Results All the incisions were healed by first intention. All the patients were followed up for 6-36 months （18 months on average）. The recovery of extremities motor function was better than that of sensory function at the early stage after operation. Muscular tension decreased after operation and mobility of limbs was improved. The operated segments were instantly stable and solid fusion was observed at 3-6 months after operation. JOA scores at 6 months after operation was 12.60 ± 0.78 with an improvement rate of 51.8%, indicating significant difference was evident when compared with the JOA scores before operation （P 〈 0.05）. The height of involved intervertebral space increased significantly to （8.20 ± 0.46） mm postoperatively, indicating th

关 键 词：颈椎间盘突出症 CAGE 多节段 内固定 

分 类 号：R687.3[医药卫生—骨科学]