颈椎前路动力性与限制性固定系统的临床比较  

Effects on Anterior Cervical Fusion Fixed with Dynamic and Constrained Anterior Cervical Plates

作　　者：杨杰[1] 贾长青[1] 刘瑞端[1] 梁峰[1] 付勤[1] 

机构地区：[1]中国医科大学盛京医院脊柱关节外科,辽宁省沈阳市110004

出　　处：《中国骨与关节损伤杂志》2010年第5期385-387,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的从临床疗效、植骨融合率、椎间高度丢失及并发症等方面分析比较颈椎前路动力性与限制性固定系统的临床应用情况。方法 2006年7月～2007年12月手术治疗颈椎病79例,随机性应用动力性钛板38例(A组),限制性钛板41例(B组)。回顾性分析两组病例的临床资料。患者在术后第1天、4周、8周、12周、6个月、12个月时复查X线片。结果平均随访15.5个月(12～18个月),所有患者JOA评分、椎间高度均较术前明显改善(P<0.05),但两组间无显著性差异(P>0.05)。A组椎间高度丢失较多(以双节段明显),两组间无显著性差异(P>0.05)。两组在术后12周时植骨融合率有显著性差异(P<0.05),但在术后6、12个月时无显著性差异(P>0.05)。结论在临床疗效及椎间高度丢失方面,动力性固定与限制性固定相比无明显差异。动力性固定系统在术后近期(3个月内)的植骨融合率较限制性固定系统高,但最终植骨融合率无差异。Objective To analyze the clinical outcomes,intervertebral height loss and rate of fusion fixed with dynamic and constrained anter/or cervical plates.Methods The data of 79 patients undergoing anterior cervical discectomy and fusion fixed with dynamic A group （38 patients） and constrained B group（41 patients） anterior cervical plates randomly were reviewed retrospectively. These patients were operated from July 2006 to December 2007.X-ray film was reviewed on 4 weeks, 8 weeks,12 weeks,6 months and 12 months in all patients. Results The follow-up time was about 15.5 months averagely （12 to 18 months）.There was a significant difference between preoperative postoperative clinical effect of both A group and B group （P〈0.05）.However,there was no significant difference between A group and B group（P〉0.05）.The intervertebral height loss of A group was more than B group （obviously in two-level cases）, without significant difference between A group and B group（P〉0.05）.The rate of fusion in A group had a significant difference compared with B group on 12weeks,without significant difference between A group and B group（P〉0.05） at the ending of follow-up.Conclusion Clinical outcomes and intervertebral height loss of dynamic anterior plates are similar to the constrained anterior plates. The rate of fusion in A group is a significant difference compared with B group on 12 weeks. There is no evidence to show that dynamic anterior plates have higher rate of fusion than constrained anterior plates at the ending of follow-up.

关 键 词：颈椎 动力性固定 椎间高度 融合 

分 类 号：R683.4[医药卫生—骨科学]