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作 者:韩成龙[1] 刘杨[1] 姜超[1] 朱洪勋[1] 杨卫良[1]
机构地区:[1]哈尔滨医科大学附属第一医院骨科,黑龙江省哈尔滨市150001
出 处:《中国组织工程研究与临床康复》2010年第35期6643-6646,共4页Journal of Clinical Rehabilitative Tissue Engineering Research
摘 要:背景:聚醚醚酮聚合物在体内外实验表明,它与人体组织有良好的相容性,最接近骨的弹性模量,并具有良好的塑性和硬度,是最佳的椎间融合器材料。目的:评价锚定聚醚醚酮椎间融合器结合纳米人工骨在脊髓型颈椎病前路间盘切除后椎体间融合效果。方法:回顾性分析2007-05/2009-09哈尔滨医科大学附属第一医院骨科收治的脊髓型颈椎病患者17例,男12例,女5例;年龄55(42~67)岁。均采用前路间盘切除后锚定聚醚醚酮融合器结合纳米人工骨椎间融合治疗。JOA评分评价神经功能恢复情况;术前、术后3个月X射线检查测量椎间高度,侧位像过伸过曲位观察融合情况。结果与结论:术后17例患者症状均有所改善,在术后的几天内,患者的下肢肌力增加,术后肢体的灵活性较术前改善。术后3个月JOA评分较术前明显提高,手术节段稳定,椎间高度恢复满意。无并发症发生,所有病例经X射线证实均达到牢固融合。结果说明锚定聚醚醚酮融合器可以使颈椎手术节段获得即刻稳定,锚定聚醚醚酮融合器结合纳米人工骨手术创伤小,手术时间短,融合效果确定,并发症较低,是治疗脊髓型颈椎病一种良好的选择。BACKGROUND: In vivo and in vitro experiments have demonstrated that polyetheretherketone (PEEK) polymer is the best cervical fusion cage material due to its good biocompatibility, elastic modulus similar to human bone, and satisfactory plasticity and hardness. OBJECTIVE: To assess the outcomes of polyetheretherketone (PEEK) cage filled with nano-artificial bone following anterior cervical discectomy and fusion (ACDF) in patients with cervical spondylotic myelopathy. METHODS: In total 17 patients with cervical spondylotic myelopathy were collected from the Department of Orthopedics, First Affiliated Hospital of Harbin Medical University between May 2007 and September 2009. There were 12 males and 5 females, averaging 55 (range 42-67) years of age. All patients underwent ACDF using PEEK cage filled with nano-artificial bone. Patients’ neurological functions were assessed on the basis of Japanese Orthopaedic Association (JOA) scoring system. The distance between the midpoint of the upper end plate and lower end plate was measured as interboby height. Radiographs with the neck in lateral flexion and extension were obtained to evaluate fusion results. RESULTS AND CONCLUSIONS: Seventeen patients with cervical spondylotic myelopathy participated in the final analysis. Almost all patients had symptomatic improvement. Within postoperative several days, muscle strength of lower limb was increased, and limb was more flexible after surgery than prior to surgery. At 3 months after surgery, JOA scores were significantly increased compared to prior to surgery, the operated segments were stable and disc space height was satisfactory. In addition, no complications were found, and all cases achieved solid fusion, as confirmed by radiographs. These findings suggest that the immediate stability of the operated segments can be obtained by anchoring PEEK cage, and the nano-artificial bone-filled PEEK cage is safe, simple, and with relatively few complications. It is therefore a good choice for patients wi
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