单用椎间融合器与加用钢板固定治疗多节段颈椎病的疗效分析  

Clinical results of using Cage only versus Cage with plate fixation in treating multiple-level cervical spondylosis

作　　者：王方[1] 吴继功[1] 邹德威[1] 马华松[1] 白克文[1] 姬勇[1] 张乐乐[1] 

机构地区：[1]解放军第306医院骨科,北京100101

出　　处：《中国矫形外科杂志》2012年第15期1365-1369,共5页Orthopedic Journal of China

摘　　要：[目的]探讨多节段颈椎前路减压椎间融合器(Cage)置入融合术(ACDF-CA)有无必要加用颈椎前路钢板固定。[方法]对2003年4月～2010年10月实行多节段颈椎前路减压手术的72例颈椎病患者进行回顾性研究。根据手术方式分2组:A组32例行颈椎前路减压单纯Cage植骨融合术(ACDF-CA),B组40例行颈椎前路减压Cage植骨融合加钢板内固定术(ACDF-CPA)。根据手术情况、症状改善情况及影像学资料对两组患者作分析比较。[结果]出血量两组无显著性差异(P>0.05),手术时间和放射性暴露时间B组比A组长(P<0.05)。术后症状改善率和融合率两组均无显著性差异(P>0.05)。两组颈椎生理曲度D值术后明显增加(P<0.01);术后随访1年时颈椎的生理前凸丢失程度A组大于B组(P<0.01)。两组椎间高度术后明显增加(P<0.01);术后随访1年椎间高度丢失程度A组大于B组(P<0.01)。[结论]多节段ACDF-CA与ACDF-CPA两种手术方式都是安全、有效的,加用钢板可以促进椎间融合、减少塌陷,有助于保持椎间高度及颈椎生理曲度。[ Objective] To research if anterior cervical plate fixation is needed after multiple - level anterior cervical de- compression and fusion with cage. [ Methods] Seventy- two patients suffered from multiple -level cervical spondylosis which were treated surgically with anterior cervical decompression and fusion form April 2003 to October 2010 were reviewed. According to the operation method , all cases were divided into 2 groups： group A, 32 cases were treated surgically with anterior cervical decompression and fusion with Cage （ACDF - CA）, group B, 40 cases were treated surgically with anterior cervical discectomy and fusion with Cage and anterior cervical plate fixation （ ACDF - CPA） . The clinical and radiography results of the two groups were compared. [ Results ] The amount of blood loss between two groups was not statistically significant （ P 〉 0.05 ）, the operation time and radioactive exposure time of group A was longer than in group B （P 〈 0. 05 ） . The symptom alleviation rate and the cervical fusion rate were not statistically significant （P 〉 O. 05） between two groups. The cervical physiology lordosis （ value of D） after operation between two groups improved significantly （P 〈 0. O1 ） . The lost degree of cervical physiology lordosis in group A was greater than in group B （ P 〈 0.01 ） after following up of one year. The height of intervertebral gap after operation between two groups improved significantly （P 〈 0. 01 ） . The lost degree of height of intervertebral gap in group A was greater than in group B （P 〈0. 01 ） after following up of one year. [ Conclusion] Multiple -level ACDF -CA and ACDF- CPA are safe and effective. Anterior cervical plate fixation helps to promot early fusion, prevent the collapse of intervertebral gap, keep the height of intervertebral space and cervical physiology lordosis.

关 键 词：颈椎病 颈椎前路减压融合术 钢板 椎间融合器 

分 类 号：R687.3[医药卫生—骨科学]