自稳型颈椎融合器用于颈椎前路双节段融合术两年以上随访观察  

Observation of stand-alone MC+polyether-ether-ketone (PEEK) Cage in anterior cervical double-level fusion for more than 2 years follow-up

作　　者：江兵[1] 陶岳峰[1] 陈海云[1] 黄小东 JIANG Bing;TAO Yuefeng;CHEN Haiyun;HUANG Xiaodong(Department of Orthopedics,Anqing Hospital Affiliated to Anhui Medical University,Anqing Anhui,246003,P.R.China)

机构地区：[1]安徽医科大学附属安庆医院骨科

出　　处：《中国修复重建外科杂志》2019年第9期1151-1155,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨采用自稳型颈椎融合器(单卡片型)行颈椎前路双节段融合术2年以上随访效果。方法回顾分析2013年1月—2016年12月,30例应用自稳型颈椎融合器(单卡片型)行颈椎前路融合术且随访2年以上患者的临床资料。男16例,女14例;年龄34~72岁,平均52.2岁。脊髓型颈椎病16例,神经根型颈椎病8例,外伤性颈椎间盘突出症6例。病变节段:C4、5、C5、6 12例,C5、6、C6、7 18例。病程3 d^24个月,平均12个月。观察术后有无颈部血肿和切口愈合情况;采用Bazaz系统评估是否存在吞咽困难;采用Suk法判断骨融合情况。术前、术后1周及末次随访时,采用日本骨科协会(JOA)评分评估神经恢复情况;行颈椎X线片检查,记录患者颈椎曲度(C2~C7 Cobb角)、融合节段椎间隙高度,并判断融合器下沉发生情况。结果患者术后均未出现颈部血肿、切口感染、食管瘘等并发症,切口均Ⅰ期愈合。30例均获随访,随访时间24~72个月,平均46个月。术后患者肢体神经症状逐渐消失,随访期间颈椎生理性曲度存在,未见明显吞咽困难及融合器下沉等内固定相关并发症的发生。术后X线片示所有患者均获得骨性融合,融合时间3~8个月,平均4.3个月。术后1周及末次随访时JOA评分、椎间隙高度与Cobb角均较术前显著改善,差异有统计学意义(P<0.05),术后1周和末次随访时比较差异无统计学意义(P>0.05)。结论在颈椎前路融合手术中应用自稳型颈椎融合器(单卡片型)能够提供早期颈椎稳定性,有效维护颈椎生理曲度和融合椎间隙高度。Objective To investigate the effectiveness of stand-alone MC+polyether-ether-ketone(PEEK)Cage(single blade type)in anterior cervical double-level fusion for more than 2 years follow-up.Methods A clinical data of 30 patients who were treated with anterior cervical fusion surgery with stand-alone MC+PEEK Cage(single blade type)between January 2013 and December 2016 and followed up for more than 2 years,was retrospectively analyzed.There were 16 males and 14 females,aged from 34 to 72 years with an average of 52.2 years.There were 16 cases of cervical spondylotic myelopathy,8 cases of cervical spondylotic myelopathy,and 6 cases of traumatic cervical disc herniation.The continuous double segments were C4,5,C5,6 in 12 cases and C5,6,C6,7 in 18 cases;and the disease duration ranged from 3 days to 24 months(mean,12 months).Postoperative neck hematoma and wound healing were observed;dysphagia was assessed by Bazaz system;and bone fusion was assessed by Suk method.Before operation,at 1 week after operation,and at last follow-up,the Japanese Orthopaedic Association(JOA)score was used to evaluate the neurological recovery;the cervical X-ray film was performed to record the cervical curvature(C2-C7 Cobb angle),the height of the intervertebral space of the fusion segment,and to judge the occurrence of the fusion Cage subsidence.Results No complication such as neck hematoma,incision infection,or esophageal fistula was found,primary healing of incisions was obtained in all cases.All patients were followed up 24-72 months(mean,46 months).Neurological symptoms such as limb numbness and pain gradually disappeared after operation;during the follow-up period,the cervical curvature could be effectively maintained;dysphagia and internal fixation related complications such as displacement of Cages were not found.All patients obtained bony fusion from 3 to 8 months with an average time of 4.3 months.Compared with preoperative ones,the JOA score,intervertebral space height,and Cobb angle of cervical spine were significantly improved at 1

关 键 词：自稳型颈椎融合器 颈椎前路融合术 椎间盘切除 

分 类 号：R687.3[医药卫生—骨科学]