应用同种异体植骨融合术治疗脊髓型颈椎病的远期疗效  

The long-term curative effect of anterior cervical discectomy and fusion with allograft in cervical spondylotic myelopathy

作　　者：李云鹏[1] 陈晓亮[1] 马进峰[1] 王德春[1] 

机构地区：[1]青岛大学医学院附属医院脊柱外科,山东青岛266003

出　　处：《颈腰痛杂志》2013年第3期205-209,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨同种异体骨在颈椎前路手术治疗脊髓型颈椎病的应用,并评价其远期疗效。方法回顾性分析自2005-01-2009-01我科31例脊髓型颈椎病患者,均采用前路减压同种异体骨植入融合钢板内固定术治疗,随访时间4～7年。采用JOA、VAS评价临床症状的改善;X线片测量颈椎高度及曲度变化并判断融合状况。结果 31例患者有5例失访,对26资料完整者记录手术时间65～115 min,平均85 min;出血量35～400 ml,平均121 ml;术后神经症状、颈肩部疼痛明显改善;X线片均未见植骨块明显移位、塌陷,未出现固定钢板松动及断裂;术后6、12个月及终访时融合率分别为45.1%、78.4%及94.1%;椎间高度较术前均有恢复,颈椎整体曲度长期维持良好状态。结论同种异体骨-前路钢板固定治疗脊髓型颈椎病操作简便,并发症状少,远期融合率满意。Objective To investigate the efficacy of anterior cervical discectomy and fusion with allografl in cervical spondylotic myelopathy so as to evaluate the long-term curative effect.Methods Thirty-one cases of anterior cervical decompression and fusion were performed with the allograft combined and anterior plate from January 2005 to January 2009. The patients were lol- lowed up from 4 to 7 years. JOA and VAS scores were used for clinical assessment. The regular Xray were used to measure the change of intervertebral height and cervical spine curvature to identify the vertebral fusion. Results Five patients were followed up for failure . The remaining 26 patients,data is complete,the operation time ranged from 65 to 115 minutes .The blooding amount was between 35 and 400 ml.After operations the neurologic symptoms,the neck and shoulder pain were significantly improved. There were no meshes found displacing or subsiding,no plate loose and breakage. After 6 months,12 months and the final follow-up fusion rates were45.1%,78.4%and 94.1% 1.The postoperative intervertebral height than before were restored and the cervical overall curvature were maintained in a good condition for a long time. Conclusion Allogeneic bone - anterior plate fixation for the treatment of cervical spondylotic myelopathy can simplify surgical procedure and reduce the postoperative complications,the long-term fusion rate is satisfactory and reliable.

关 键 词：颈椎病 脊柱融合术 同种异体植骨 临床疗效 

分 类 号：R681.55[医药卫生—骨科学]