颈前路减压融合术后相邻节段异位骨化的危险因素分析  

Risk Factors for Adjacent-level Ossification after Aterior Cervical Decompression and Fusion

作　　者：陈昆[1] 刘爱刚[1] 蔡惠民[1] 

机构地区：[1]解放军第180医院骨一科,福建泉州362000

出　　处：《实用骨科杂志》2017年第3期198-202,216,共6页Journal of Practical Orthopaedics

基　　金：泉州市科技局社会发展计划重点项目(2013Z117);石狮市科技计划项目(2013SK11)

摘　　要：目的讨论不同手术方式对颈椎前路减压融合术(anterior cervical discectomy and fusion,ACDF)后相邻节段异位骨化的影响,并讨论颈椎前路减压融合术后相邻节段异位骨化的相关危险因素。方法 2009年6月至2013年8月我科采用零切迹颈前路减压间融合固定术治疗颈椎间盘突出症51例,同时期采用常规ACDF钛板结合Cage病例54例,记录一般情况,对手术相关指标、功能评分、症状评分以及包括钢板摆放位置在内的影像学指标进行记录及分析,结合目前已有的多方研究意见,对钛板结合cage及零切迹椎间融合术后相邻节段异位骨化进行相关因素分析。结果手术方式的选择、高龄、女性、术中出血过多、症状改善率不佳、钛板距离椎体边缘过近、骨质疏松是ACDF术后相邻节段异位骨化的危险因素。结论使用Zero-P、抗骨质疏松治疗、减少术中出血、选用合理长度的钛板和合适的摆放位置可降低术后相邻节段异位骨化的发生。Objective To analyze the risk factors for adjacent-level ossificationskin after anterior cervical decompres-sion and fusion.Methods The clinical data of 105 patients with cervical intervertebral disc herniation who underwent anterior cervical discectomy and fusion（ACDF）by Zero-P implant（n=51 ）or traditional titanium plate with cage（n=54）between June 2009 and August 2013 were retrospectively analyzed.The Bazaz dysphagia grading、the Neck Disabili-ty Index（NDI）、Japanese Orthopaedic Association （JOA）scoring、ameliorative rate of symptom in both groups were measured and compared.The radiographs of the cervical spine were made to assess plate-to-dis distance and adjacent-level ossification development.Results Surgical method,age,gender,blood loss,ameliorative rate of symptom,plate-to-dis distance and Osteoporosis were risk factors of calcaneal incision complications.Conclusion It is helpful for avoiding adjacent-level ossification after nterior cervical decompression and fusion by using Zero-P,anti-osteoporosis treatment before operation,reducing blood loss,suitable plate and find-out the suitable position for the plate.

关 键 词：颈椎前路减压融合术 相邻节段 异位骨化 危险因素 

分 类 号：R681.55[医药卫生—骨科学]