不同植骨融合方式对脊髓型颈椎病患者术后椎间高度的影响  

Influence of different fusion methods in intervertebral height of patients with cervical spondylotic myelopathy after cervical anterior corpectomy

作　　者：管俊杰[1] 张烽[1] 赵剑[1] 陈晓庆[1] 

机构地区：[1]南通大学附属医院骨科,江苏南通226001

出　　处：《中国临床解剖学杂志》2014年第2期214-216,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的探讨分析不同植骨融合方式对脊髓型颈椎病患者术后椎间高度的影响。方法选取65例2010年5月～2012年7月间于我院接受颈前路椎体次全切除减压融合术的脊髓型颈椎病患者，将20例在术中接受自体髂骨植骨融合的患者作为对照组，20例在术中接受无端盖钛网植骨患者作为无端盖钛网组，25例在术中接受有端盖钛网植骨的患者作为有端盖钛网组。比较不同组别患者手术前后椎间高度的变化及术后并发症的发生率。结果3组术前、术后即刻与术后1年融合节段椎体前后缘高度的差异比较无统计学意义（P〉0．05），但有端盖钛网组术后融合节段椎体前后缘高度的降低值要明显低于对照组与无端盖钛网组（P〈0．05），且术后并发症的发生率要明显低于其余两组（8％vs45％，40％；x2=8．236，6．583；P=0．004，0．010）。结论组配式端盖的钛网在颈前路椎体次全切除减压融合术中的应用更好地维持了椎间高度，降低了钛网沉陷的发生率，故值得推广。Objective To study the influence of different fusion methods in intervertebral height of patients with cervical spondylotic myelopathy after cervical anterior corpectomy. Methods 65 patients with cervical spondylotic myelopathy who accepted cervical anterior corpectomy during May, 2010 to July, 2012 were selected. 20 patients accepting autogenous iliac bone grafting were divided into the control group. 20 patients accepting titanium mesh cages without end caps were divided into the non-caps group while 25 patients accepting titanium mesh cages with modular end caps were divided into the modular caps group. The change of intervertebral height of patients before and after the surgery and the incidence of the complication of all the patients were compared. Results The difference of height of the anterior border and posterior border before and after the surgery was not statistically significant （P〉0.05）. The loss of the height of the anterior and posterior borders of the intervertebral height of the modular caps group in 1 year after the surgery was statistically less than that of the other two groups（P〈0.05）. The incidence of the modular caps group after the surgery was statistically less than that of the other two groups （8% vs 45%, 40%; x2=8.236, 6.583 P=0.004, 0.010）. Conclusion The application of modular end caps in cervical anterior corpectomy could maintain the cervical intervertebral height postoperatively and reduce the postoperative subsidence rate of titanium mesh cage, which is worth further promotion.

关 键 词：脊髓型颈椎病 植骨融合 椎间高度 

分 类 号：R681.5[医药卫生—骨科学]