纳米人工骨Cage与自体骨治疗相邻两节段颈椎病的疗效比较  

Outcome comparison between the use of nano- artificial bone cage and autografts to treat two- level continuous cervical spondylosis

作　　者：李名武[1] 于洋[1] 倪斌[2] 郭群峰[2] 路燕燕[1] 董明岩[1] 

机构地区：[1]辽宁医学院附属第一医院骨科,锦州121001 [2]第二军医大学附属长征医院骨科,上海200003

出　　处：《中国矫形外科杂志》2013年第19期1940-1946,共7页Orthopedic Journal of China

基　　金：辽宁省教育厅课题(项目编号L2011146)

摘　　要：[目的]比较颈前路减压纳米人工骨Cage融合与自体髂骨块植骨融合治疗相邻两节段脊髓型颈椎病的近、中期疗效。[方法]按纳入标准收集2009年1月～2012年4月在本院行颈前路相邻两节段椎间盘摘除、椎间植骨融合钛板内固定术的病人病历资料,按植骨材料分为A、B两组,A组32例为自体髂骨植骨,B组24例为纳米人工骨Cage植骨,观察手术时间、术中出血量、术前、术后JOA评分、NDI评分;术前、术后拍颈椎侧位、动力位X线片,随访观察术后3、6、12个月时的颈椎侧位、动力位X线片,观察比较各时间点植骨融合率、椎间隙高度、颈椎曲度及颈椎活动度,对以上指标行组间t检验。[结果]两组术中出血量无差异,术后JOA、NDI评分均较术前明显改善,但两组术后不同时间点JOA、NDI评分功能改善率比较无差异;JOA评分功能改善率在术后6个月时最高。两组的融合率比较差异无统计学意义。两组患者手术时间,差异有统计学意义。B组术后颈椎曲度改善较A组好;术后3、6、12个月时A/B两组的颈椎曲度丢失、椎间隙高度丢失差异均有统计学意义。[结论]颈前路减压自体髂骨植骨融合钛板内固定术与颈前路减压纳米人工骨Cage植骨融合钛板内固定术治疗相邻两节段脊髓型颈椎病的近、中期疗效均较好,但后者手术时间短,近期并发症少,对椎间隙高度及颈椎曲度的维持更好。[ Objective ] To compare the short - and long - term outcomes of using the nano - artificial bone cage and auto- grafts in anterior cervical discectomy for two - level continuous cervical spondylosis. [ Methods ] From January 2009 to April 2012, the patients who underwent two - level contiguous anterior cervical discectomy and interbody fusion in our hospital were divided into 2 groups based on the fusion materials used. Group A included 32 cases with autologous fusion and group B included 24 cases with nano - artificial bone cage fusion. The following were analyzed： time taken for surgery, bleeding volume, and JOA and NDI score before and after surgery. The data on fusion rate, cervical lordosis, cervical interspace height, and range of motion were recorded using lateral and flexion - extension cervical spine radiographs. The data were analyzed using the inde- pendent samples t - test. [ Results ] A significant difference was noted in the bleeding volume of groups A and B. The JOA and NDI scores improved in both groups after surgery. The JOA score was highest at 6 months after surgery. The fusion rates and the time taken for surgery showed no significant differences between the 2 groups. However, cervical lordosis and interspace height were better maintained in group B than in group A. [ Conclusion] Autografis and nano - artificial bone cage fusion are both ef- fective in the short and long term for two - level continuous anterior cervical discectomy ; however, the latter is more effective in maintaining cervical lordosis and cervical interspace height.

关 键 词：相邻两节段 颈椎病 融合 纳米人工骨Cage 

分 类 号：R687.3[医药卫生—骨科学]