自锁式双固定嵌片融合器在颈椎前路融合术中的应用  

The application of self-locking double fixation fusion cage in anterior cervical fusion

作　　者：高鑫 厉晓龙[1] 刘伟峰[1] 朱洲[1] 邵建树[1] 季旭彪 GAO Xin;LI Xiao-long;LIU Wei-feng;ZHU Zhou;SHAO Jian-shu;JI Xu-biao(Dept of Orthopaedics,the Affiliated Wujin Hospital of Jiangsu University,Changzhou,Jiangsu213017,China)

机构地区：[1]江苏大学附属武进医院骨科,江苏常州213017

出　　处：《临床骨科杂志》2018年第2期129-131,共3页Journal of Clinical Orthopaedics

摘　　要：目的观察颈椎自锁式双固定嵌片融合器(ROI-C)在颈椎前路融合术中的应用效果。方法对26例脊髓型颈椎病患者(31个椎间隙)行颈椎前路髓核摘除并应用ROI-C行椎间融合术。记录手术时间、术中出血量;观察术后脊髓受压、术后吞咽情况以及ROI-C位置和颈椎融合情况;采用JOA评分评价术后及随访时神经功能恢复情况。结果手术时间55~80(66.2±9.4)min;术中出血量20~65(38.8±14.9)ml。患者术后第1天症状均得到明显改善。患者均获得随访,时间18~44个月。至末次随访时,所有患者融合椎体无畸形,ROI-C无移位,无主诉吞咽困难或颈部异物感。JOA评分术后6个月及末次随访时均显著高于术前水平,差异有统计学意义(P<0.01);末次随访与术后6个月比较差异无统计学意义(P>0.05)。结论对颈椎管前方无明显骨性压迫且不伴有颈椎不稳及椎管狭窄的脊髓型颈椎病患者,采用颈椎前路髓核摘除联合ROI-C治疗,可取得满意的临床疗效。Objective To observe the effect of self-locking double fixation fusion cage(ROI-C)in anterior cervical decompression and fusion.Methods The 26 patients with cervical spondylotic myelopathy(31 intervertebral discs)were treated by anterior cervical decompression and fusion,and ROI-C system was used for interbody fusion.The operation time,intraoperative blood loss were recorded.Postoperative spinal cord compression,postoperative dysphagia,the location of ROI-C system and cervical fusion were observed.JOA scoring was used to evaluate postoperative and follow-up of neurological function recovery.Results The operative time ranged from 55~80(66.2±9.4)min.The average blood loss was 20~65(38.8±14.9)ml.The 26 patients symptoms improved significantly at the postoperative 1 d.All patients were followed up for 18~44 months.At the last follow-up,all patients had not changed in fused vertebral deformity,moving fusion system.None of the patients complained of dysphagia or neck foreign body sensation.At postoperative 6 months and last follow-up,JOA scores were significantly higher than the preoperative level,the difference were statistically significant(P<0.01),while there was no statistical difference between the last follow-up and postoperative 6 months(P>0.05).Conclusions The satisfied clinical efficacy of anterior cervical decompression combined ROI-C with anterior cervical decompression is achieved in patients with no apparent bone compression in the front of cervical vertebral canal,without cervical instability and spinal stenosis.

关 键 词：脊髓型颈椎病 颈椎前路减压融合 ROI-C 

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