两种手术方法在两节段颈椎退行性疾病的疗效比较  

Comparison of Two Surgical Approches in Two-level Cervical Degenerative Disease

作　　者：陈强[1] 王志成[1] 马恩元[1] 

机构地区：[1]北华大学附属医院骨一科,吉林吉林132000

出　　处：《中国现代医生》2011年第31期58-60,共3页China Modern Doctor

摘　　要：目的对比研究颈椎前路椎间盘切除植骨(ACDF)单纯cage内固定术与ACDF锁定钢板内固定术对两节段颈椎退行性疾病的疗效。方法回顾性研究42例采用了ACDF的两节段颈椎退变患者,其中22例采用了单纯cage内固定,20例采用锁定钢板内固定术,比较两组的影像及临床结果。随访时间为2年。结果大部分患者的颈后疼痛以及前臂疼痛症状均较术前有所改善。两组的融合率、沉降率、后凸成角、邻近节段退变方面无明显统计学差异。ACDF锁定钢板内固定组出现1例钢板松动,在ACDF锁定钢板内固定组出现2例吞咽困难。两组均未见cage的前移、脱位以及假关节的形成。结论在两节段的ACDF时,单纯cage内固定与锁定钢板内固定在影像与临床结果方面无明显统计学差异。我们认为在两节段的ACDF时常规采用锁定钢板螺钉是不可取的。Objective This study assessed the efficacy of anterior cervical discectomy and fusion （ ACDF ） with cage alone compared with ACDF with plate instrumentation for radiologic and clinical outcomes in two-level cervical degenerative disease. Methods A total of 42 patients with two-level cervical degenerative disc disease were assessed retrospectively. 22 patients who underwent ACDF with cage alone were compared with 20 patients who underwent ACDF with plate fixation in consideration of radiologic and clinical outcomes. Follow-up lasted 2 years. Results In both groups, most of all patients＇ clinical symptoms such as posterior neck pain, arm pain were improved compared with preoperative symptoms. There were no significant difference between both groups in fusion rates, subsidence rates, kyphotic angle and adjacent level disease. Plate loosening developed in 1 case in ACDF with plate fixation group. Swallowing difficulty occurred in 2 cases of the ACDF with plate fixation group. Anterior migration or displacement of the cage, pseudoarthrosis was not developed in any cases of both two groups. Conclusion In two-level ACDF, ACDF with cage alone would be comparable with ACDF with plate fixation with regard to clinical outcome and radiologic result with no significant difference. We suggest that the routine use of plate and screw in 2-level surgery may not be beneficial.

关 键 词：ACDF单纯cage内固定 ACDF锁定钢板内固定 融合率 沉降率 相邻节段退变 

分 类 号：R687.3[医药卫生—骨科学]