纳米羟基磷灰石椎间融合器与钛钢板固定在颈椎病前路手术中的应用  

N-HA / PA66 cage and titanium plate fixation for treatment of cervical disc herniation

作　　者：徐文华 谭明生[2] 杨峰[2] 移平[2] 唐向盛[2] 

机构地区：[1]江西省宜春市人民医院骨科,336000 [2]北京中日友好医院脊柱外科,100029

出　　处：《中国矫形外科杂志》2016年第13期1170-1174,共5页Orthopedic Journal of China

摘　　要：[目的]探讨纳米羟基磷灰石椎间融合器与钛钢板治疗颈椎间盘突出症的临床效果。[方法]选择2013年6月～2015年1月中日友好医院脊柱外科采用颈椎前路椎间盘切除减压并纳米羟基磷灰石椎间融合器与钛钢板治疗的颈椎间盘突出症患者47例,单节段11例,双节段26例,三节段10例;其中脊髓型颈椎病21例,神经根型颈椎病26例。[结果]47例患者手术均顺利完成,无术后相关并发症发生,所有患者均获随访,时间3～18个月,平均10个月,术后末次JOA、NDI评分较术前均明显提高[（9.8±2.3）vs.（12.7±2.5）;（23.1±5.7）vs.（32.5±6.1）],差异有统计学意义（P〈0.05）;所有患者均获骨性融合,平均融合时间4个月,未出现融合器移位及下沉等情况。椎体间隙高度[（7.47±1.02）mm vs.（5.19±0.88）mm,P〈0.05]、颈椎生理曲度[（7.04±1.04）mm vs.（3.51±2.01）mm,P〈0.05]较术前明显恢复,差异有统计学意义（P〈0.05）。[结论]纳米羟基磷灰石椎间融合器与钛钢板治疗颈椎间盘突出症,手术创伤不大,融合率高,能有效恢复椎体间隙高度及颈椎生理曲度,改善神经功能,术后效果良好。[Objective] To study the clinical effects of operative treatment of cervical disc herniation with N- HA / PA66 cage and anterior cervical titanium plate fixation. [Methods] Forty- seven patients with cervical disc herniation,which located in mono- segment in 11 patients,double- segment in 26 patients and three- segment in 10 patients,were admitted to China Japan Friendship Hospital From June 2013 to January 2015,and were treated with N- HA / PA66 cage fusion and anterior cervical titanium plate fixation. Twenty- one cases were diagnosed as cervical spondylotic myelopathy and twenty- six as cervical spondylotic radiculopathy. [Results] All cases were operated successfully and postoperative complications were not found. Patients were followed up for an average of 10 months（ range,3 to 18 months）. The post- operative Japanese Orthopedic Association（ JOA） score and neck disability index（ NDI） score were better than those of pre- operation [（ 9. 8 ± 2. 3）vs.（ 12. 7 ± 2. 5）;（ 23. 1 ± 5. 7） vs.（ 32. 5 ± 6. 1） ],the differences were statistically significant（ P〈0. 05）. Displacement and subsidence of cages were not found,and the bony fusion was achieved in all cases,the average time of bone graft fusion was 4 months. Intervertebral space height increased from（ 7. 47 ± 1. 02） mm to（ 5. 19 ± 0. 88） mm,and physiological curvature of the cervical spine increased from（ 7. 04 ± 1. 04） mm to（ 3. 51 ± 2. 01） mm,indicating statistically significant differences as well（ P〈0. 05）. [Conclusion] Cervical disc herniation can be safely and micro- invasively operated with N- HA / PA66 cage and anterior cervical titanium plate fixation. This technique has advantages of a higher fusion rate,better intervertebral height,and physiological curve increasing,and consequently,a better nerve function improvement.

关 键 词：颈椎病 脊椎融合术 椎间盘切除术 

分 类 号：R687.3[医药卫生—骨科学]