椎间盘及部分椎体切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘突出伴椎体后缘骨赘  

Disckectomy,Partial Adjacent Centrum Resection,Bone Graft with Titanium Mesh and Titanium Plate Fixation for the Treatment of Single Segment Cervical Disc Degeneration with Adjacent Vertebral Posterior Osteophyte

作　　者：孙继飞[1] 何强[1] 刘振利[1] 陈庆胜[1] 

机构地区：[1]中国人民解放军第251医院骨二科,张家口075000

出　　处：《中国现代手术学杂志》2012年第1期35-37,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的评价颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘退变突出伴相邻椎体后缘骨赘的疗效。方法应用颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘退变突出伴相邻椎体后缘骨赘22例。取颈椎前路手术切口,术中仅切除突出的椎间盘及相邻椎体的1/3～1/2,使脊髓得到彻底的减压。再用填满碎骨的钛网植于骨缺损处加用钛板螺丝钉内固定,固定范围仅限于相邻椎体。术前和术后通过神经功能JOA评分、颈部轴性症状、颈椎动态侧位片和颈椎MRI比较临床疗效。结果均获随访,平均15(6～24)个月,术后JOA评分优良率86.4%,颈部轴性症状减轻,脊髓功能明显得到恢复。颈椎活动度良好。X线检查见钛网植骨及钛板内固定良好,未见不稳现象。MRI示颈髓压迫解除。结论颈椎椎间盘及相邻椎体部分切除加钛网植骨钛板内固定术治疗单节段颈椎椎间盘突出伴相邻椎体骨赘效果显著,可最大限度地保留颈椎节段的活动度。Objective To evaluate the clinical effects of disckectomy,partial adjacent centrum resection,bone graft with titanium mesh and titanium plate fixation for the treatment of single segment cervical disc degeneration with adjacent vertebral posterior osteophyte.Methods There were 22 cases received this kind of surgical procedure.By anterior cervical incision,the herniated disc and only 1/3 to 1/2 of the adjacent vertebral body were removed for the decompression of the spinal cord.Then the titanium mesh filled with the small bones was implanted in the bone defect followed by titanium screw fixation.The fixation was limited to the adjacent vertebral bodies.Preoperative and postoperative neurological functions of the JOA score,the cervical axial symptoms,the cervical dynamic radiographs and cervical spine MRI were used to compare the clinical efficacy. Results All patients were followed up for 15（6 to 24） months.The postoperative good rate of JOA score was 86.4%.All symptoms of axial neck released and the spinal cord function got restored.The cervical activity was good.X-ray examination showed the titanium mesh cage and plate fixation well,no instability phenomena.MRI showed the spinal cord decompressed.Conclusion It shows significant effect of disckectomy,partial adjacent centrum resection,bone graft with titanium mesh and titanium plate fixation for the treatment of single segment cervical disc degeneration with adjacent vertebral posterior osteophyte,and can retain the maximum activity of cervical segments.

关 键 词：颈椎病 椎间盘移位 椎间盘切除术 内固定器 

分 类 号：R687.3[医药卫生—骨科学]