ROI-C双锚定自锁式融合器在颈椎前路手术的应用  

Application of double-anchoring self-locking cages for the anterior cervical discectomy and fusion

作　　者：李国[1] 严力生[1] 钱海平[1] 罗旭耀[1] 宫峰[1] 吴建峰[1] 

机构地区：[1]解放军第411医院骨科,上海200081

出　　处：《颈腰痛杂志》2015年第2期105-109,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨使用双锚定自锁式融合器（ROI-C）的颈前路手术治疗脊髓型颈椎病的临床效果。方法 2012-01-2014-03,采用颈前路椎间盘切除减压双锚定自锁式椎间融合器固定治疗脊髓型颈椎病43例（88个椎节）,记录术前和末次随访SF-36健康调查评分评估治疗结果 ;在各个随访时间点拍摄颈椎侧位X线片,测量病变椎间隙高度、颈椎整体曲度以判定颈椎的即时稳定性和植骨融合情况,采用重复测量方差分析结果。结果 JOA评分由术前平均（6.2±2.9）分增加至术后平均（12.9±1.6）分,具有统计学意义（F=16.25,P=0.001）,优良率为90.6%。SF-36健康所选维度评分较术前均有显著改善（t=1.098~11.897,P〈0.05）。椎间隙高度由术前平均（5.2±1.7）mm,末次随访时平均（7.9±0.6）mm,差异具有统计学意义（F=10.28,P=0.039）;颈椎整体曲度变化由术前平均5°±7°,至末次随访时平均为9°±13°,有统计学意义（F=216.27,P=0.000）。2例患者分别出现声音嘶哑和吞咽困难,术后2周自愈。术后6个月拍摄X线片或行CT检查证实,88个融合节段都获骨性融合。结论颈椎前路减采用双锚定自锁式颈椎间融合器能有效恢复颈椎间隙高度和生理弧度,提供颈椎即刻稳定性,植骨融合率高,临床效果满意。Objective To discuss the efficacy of a new double-anchoring self-locking cage （ROI-C） in the anterior cervical discotomy and fusion （ACDF） to treat cervical spondylotic myelopathy. Methods ACDF with double-anchoring self-locking cages was performed in 43 patients（88 levels） between January 2012 and March 2014. The Japanese Orthopaedics Assicia- tion（JOA） and SF-36 score were recorded pre-operatively and in the follow-up time point to e- valuate the clinical outcome. Meanwhile,the preoperation and postoperation X-ray films were ac- cumulated to measure the height of interhody space,whole curvature of cervical spine and the rate of fusion for repeated measures analysis of variance. Results The mean follow-up time was 18.3 months （6~31 months）. In the last follow-up time,JOA scores increased from preoperation（6. 2±2.9） to （12.9±1.6）（F=16.25,P=0.001）,the excellent and good rate was 90.6%. All the scores of SF-36 improved significantly （t=1.098°11.897,P〈0.05）. The height of the disc space in- creased from preoperation （5.2±1.7） mm to （7.9±0.6） mm （F=10.28,P=O.039）,the curvature of the whole cervical spine increased from preoperation（5°±7° ） to postoperation（9°±13°） （F=216.27, P=O.OOO）,the differences of two parameters were significant respectively. Dysphagia in one pa-tient and hoarseness in another patient were found,both of the two cases were recovered sponta- neously in two weeks. All of the 43 cases （88 levels） achieved bony fusion in six months. Con- clusion There are many advantages in ACDF with the double-anchoring self-locking cage,such as simple operation,minimally invasive procedure,reliable orthopaedic ability,provision of immediate segmental stability,high fusion rate ,optimistic treatment outcome.

关 键 词：脊柱融合术 颈椎椎间融合器 脊髓型颈椎病 

分 类 号：R687.32[医药卫生—骨科学]