前路C-jaws内固定器治疗单节段脊髓型颈椎病  

Effect analysis of anterior cervical C-jaws cervical pressure internal fixator in the treatment of single-stage cervical spondylosis

作　　者：朱斌[1] 荆珏华[1] 田大胜[1] 陈磊[1] ZHU Bin;JING Jue-hua;TIAN Da-sheng;CHEN Lei(Department of Orthopedics,the Second Affiliated Hospital of Anhui Medical Universityf Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院骨科,合肥230601

出　　处：《中国矫形外科杂志》2020年第17期1563-1567,共5页Orthopedic Journal of China

摘　　要：[目的]探讨颈椎前路C-jaws颈椎内固定器治疗单节段脊髓型颈椎病的疗效。[方法]回顾分析2015年~2016年48例诊断为单节段脊髓型颈椎病患者资料。临床指标包括围手术期情况、累及区肌力、感觉、病理反射,以及疼痛视觉模拟评分(visual analogue scale,VAS)和日本骨科协会(Japanese Orthopaedic Association,JOA)颈椎评分评价临床结果;影像学指标包括测量椎管面积、椎间隙高度和局部Cobb角,评价内固定情况以及邻近椎间隙退变的程度。[结果]手术时间(46.30±15.20)min,术中出血量(45.00±23.50)ml。术后所有患者均未出现发音嘶哑、吞咽困难等症状。48例患者随访36~52个月,平均(41.60±11.20)个月。术后3个月门诊随访显示累及区肌力、感觉、病理反射较术前均有明显改善。末次随访VAS评分为(1.60±0.61)分,低于术前的(8.15±0.52)分(P<0.05);JOA评分为(15.30±0.92)分,高于术前的(7.42±0.60)分(P<0.05)。末次随访影像显示椎管面积、椎间隙高度及局部后凸Cobb角显著增加(P<0.05)。所有患者均达到手术节段骨性融合,其中1例患者内固定轻度前移,其余患者内固定位置良好。其中3例上、下邻近节段轻度退变,无明显退变病例发生。[结论]颈椎前路压力内固定器固定融合术治疗单阶段脊髓型颈椎病的疗效满意,术后邻近节段椎间盘退变发生率低。[Objective]To evaluate the efficacy of anterior cervical C-jaws cervical pressure internal fixator in the treatment of single-stage cervical spondylosis.[Method]Data of 48 patients diagnosed with cervical spondylosis from July 2015 to August 2016 were retrospectively analyzed.The patients were 25 males and 23 females,aged 33~63 years,with an average age of 49.5 years.There were 18 cases of cervical spondylotic radiculopathy and 30 cases of cervical spondylotic myelopathy.All patients received anterior cervical C-jaws cervical pressure fixator combined with intervertebral bone graft fusion device for internal fixation,and the follow-up was more than 3 years.A total of 48 C-jaws were implanted.C3/4,C4/5,C5/6,and C6/7 intervertebral intervertebral implants of C-jaws were 6,14,25,and 3,respectively.Clinical and imaging indicators were assessed at 3 months,6 months,1 year and 3 years after surgery.Clinical indicators included the incidence and duration of postoperative deglutition discomfort,the changes in VAS score(radiculopathy)and JOA score(spondylotic myelopathy).Imaging indicators included the evaluation of internal fixation by anterior and lateral cervical X-ray examination and the degree of degeneration of adjacent intervertebral space observed by cervical MRI.[Result]Follow-up ranged from 36 to 52 months,with an average follow-up of(41.60±11.20)months.VAS scores of patients with cervical spondylotic radiculopathy were(1.60±0.61)and(1.42±0.80)at 3 months after surgery and the last follow-up,both lower than(8.15±0.52)before surgery(P<0.05).The JOA scores of patients with cervical spondylotic myelopathy at 3 months after surgery and the last follow-up were(15.30±0.92)and(16.81±2.30),respectively,higher than the(7.42±0.60)scores before surgery.Eleven patients had swallowing pain after the operation,10 of them gradually disappeared within 3 months after the operation,and one patient’s symptoms disappeared within 6 months after the operation.The cervical Cobb Angle was(18.60±7.90)°and(18.70±9.82)°at 3 m

关 键 词：颈椎前路 颈椎病 C-jaws内固定系统 疗效 

分 类 号：R681.55[医药卫生—骨科学]