颈椎桥形固定嵌片融合器在颈椎间盘切除融合术中的应用  

Clinical application of double-way connection intervertebral fusion device for anterior cervical discectomy and fusion

作　　者：张大鹏[1] 强晓军[1] 王振江[1] 刘涛[1] 杨光[1] ZHANG Da-peng, OIANG Xiao-jun, WANG Zhen-jiang, LIU Tao, YANG Guang(Section Ⅰ ,Dept of Orthopaedics,Puyang Oilfield General Hospital, Puyang, Henan 457001, China)

机构地区：[1]濮阳市油田总医院骨一科,河南濮阳457001

出　　处：《临床骨科杂志》2018年第4期391-394,共4页Journal of Clinical Orthopaedics

摘　　要：目的分析使用颈椎桥形固定嵌片融合器(ROI-C)进行颈椎前路手术治疗颈椎病的临床效果。方法采用ROI-C进行颈椎前路手术治疗44例颈椎病患者(56个节段)。记录手术时间及出血量,对手术前后患者颈椎曲度、病变椎间隙高度、病变节段融合、邻近节段退变情况进行评价,应用JOA评分及VAS评分评估手术前后神经恢复情况及颈部局部症状改善情况,并记录手术并发症。结果患者均获得随访,时间6～12个月。手术时间60～150(85.4±10.4)min,出血量20～150(60.0±11.7)ml。颈椎曲度和病变椎间隙高度:术后3d、1个月及末次随访时均较术前显著增加,差异有统计学意义(P<0.05),术后各时间点之间比较差异无统计学意义(P>0.05)。JOA评分及VAS评分:术后7 d、1个月及末次随访均较术前有明显改善,差异有统计学意义(P<0.05),而术后不同时间点比较差异无统计学意义(P>0.05)。末次随访时42例获得骨性融合,融合率达95.5%。未发生邻近节段退变。术后2例(4.5%)出现轻度吞咽困难,1例(2.3%)出现声音嘶哑,2例(4.5%)出现不同程度轴性症状,经对症治疗后均治愈。结论应用ROI-C进行颈椎前路椎间盘切除融合术,组织损伤少,能有效恢复并长时间维持病变椎体间隙高度及颈椎曲度,提供早期椎体间稳定,椎体融合率高,并发症发生率低,临床效果满意。Objective To analyse the clinical efficacy of double-way connection intervertebral fusion device（ ROI-C）in the treatment of cervical spondylosis. Methods A total of 44 patients（ 56 vertebral segments） with the cervical spondylosis were treated with ROI-C. Operation time,intraoperative blood loss,incidence of postoperative dysphagia,JOA scores and VAS,the height of intervertebral space,fusion rate and complications were observed to analyse the clinical effects. Results All patients were followed up for 6 ～ 12 months. The operation time was 60 ～ 150（ 85. 4 ±10. 4） min,intraoperative blood loss was 20 ～ 150（ 60. 0 ± 11. 7） ml. At 3 d,1 month postoperation and last follow-up,cervical curvature and intervertebral space height significantly increased compared with the preoperation（ P 0. 05）,but there was no significant difference between the different time points after the operation（ P 0. 05）. At postoperative 7 d,1 month and last follow-up,JOA score and VAS improved significantly compared with the preoperative（ P 0. 05）,but no significant differences existed between the different time points after the operation（ P 0. 05）. At the last follow-up,42 patients got bony fusion,with the fusion rate of 95. 5%; adjacent segment degeneration did not occur; dysphagia occurred in 2 patients（ 4. 5%） after operation,1 case（ 2. 3%） of hoarseness,2 cases（ 4. 5%） with varying degrees of axial symptoms,cured after treatment. Conclusions Application of ROI-C for anterior cervical discectomy and fusion has less tissue damage,and it can effectively restore and maintain the height of intervertebral space and cervical curvature,providing early intervertebral stability,high vertebral fusion rate and low complication rate,and the clinical effect is satisfactory.

关 键 词：颈椎病 颈椎间盘切除术 颈椎融合术 桥形椎间锁定融合器 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]