在退变性颈椎后凸畸形手术中应用纳米羟基磷灰石/聚酰胺66人工椎体的疗效观察  

Clinical efficacy of nano-hydroxyapatite/polyamide 66 strut for degenerative cervical kyphosis

作　　者：钟伟洋[1] 王林 彭俊木 黄天霁 罗小辑[1] Zhong Weiyang;Wang Lin;Peng Junmu;Huang Tianji;Luo Xiaoji(Department of Orthopedic surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;不详)

机构地区：[1]重庆医科大学附属第一医院骨科,400016 [2]重庆市第九人民医院骨科,400799

出　　处：《骨科临床与研究杂志》2023年第1期22-26,共5页Journal Of Clinical Orthopedics And Research

基　　金：重庆市科卫联合项目(2021MSXM285)。

摘　　要：目的探讨在退变性颈椎后凸畸形手术中应用纳米羟基磷灰/聚酰胺66人工椎体(n-HA/PA66 strut)的疗效。方法2014年1月至2021年1月在重庆医科大学附属第一医院骨科行颈椎后凸畸形手术且具备完整随访资料的患者31例。记录性别、年龄、出血量、手术时间、并发症发生率等基本信息。影像学评价包括颈椎曲度、颈椎过伸过屈曲度、局部节段曲度、局部节段过伸过屈曲度,采用Brantigan评分判断植骨融合。临床疗效采用JOA评分、VAS评分和NDI评价。结果随访(21.6±10.9)个月。患者年龄、病程、手术时间、术中失血量、住院费用、住院时间分别为(50.5±13.0)岁、(18.2±21.9)个月、(134.3±57.0)min、(110.3±128.1)ml、(54406±17703)元、(10.7±5.1)d。末次随访时VAS、NDI和JOA评分较术前明显改善(P<0.05)。末次随访颈椎曲度、颈椎过伸曲度、颈椎过屈节曲度、局部节段曲度、局部节段过伸曲度、局部节段过屈曲度较术前明显改善(P<0.05)。术后出现2例并发症,1例术后出现前路切口血肿,经急诊手术,术后恢复良好;1例出现后路深部切口粘质沙雷菌感染,清创和抗感染治疗后恢复可。术后融合时间为(4.1±1.3)个月。2例人工椎体出现下沉,下沉率为6.45%。结论n-HA/PA66人工椎体在颈椎后凸畸形手术可以很好维持融合节段高度及曲度,下沉率低,融合效果好。Objective To investigate the clinical efficacy of the nano-hydroxyapatite/polyamide 66 strut for degenerative cervical hosis.Methods From January 2014 to January 2021,The data of 31 patients who underwent the correction surgery of cervical kyphosis with complete follow-up were retrospectively analyzed.The gender,age,intraoperotive blood loss,surgery time,complications etc were recorded.The imaging assessment included cervical curvature,cervical curvature of cervical hyperextension and hyperflexion,segmental curvature,segmental curvature of hyperextension and hyperflexion.Brantigan score was used for the bone fusion.The clinical efficacy was evaluated by VAS,JOA and NDI.Results The patients had follow-up of(21.6±10.9)months.The age,course of disease,surgery time,intraoperotive blood los,hospitalization cost and hospital stay were(50.5±13.0)years,(18.2±21.9)months,(134.3±57.0)min,(110.3±128.1)ml,(54406±17703)yuan and(10.7±5.1)days respectively.There were 27 cases of anterior approach and 4 cases of combined anterior and posterior approaches.At the final follow-up,the VAS,NDI and JOA scores were significantly improved compared with those preoperatively(P<0.05).The cobb angle of the cervical curvature,cervical curvature of cervical hyperextension and hyperflexion,segmental curvature,segmental curvature of hyperextension and hyperflexion were significantly improved compared with those preoperatively(P<0.05).Postoperative complications occurred in 2 cases.The incision hematoma in one case which was removed in emergency.One patient who underwent combined anterior and posterior surgeries developed posterior incision infection of Serratia marcescens.After the debridement and antibiotic therapy,the incision recovered.The mean bone fusion time was(4.10±1.30)months.Two cases subsided with a subsidence rate of about 6.45%.Conclusion The n-HA/PA66 strut could maintain the height and curvature of fused segment for degenerative cervical kyphosis,with low subsidence rate and good fusion efficacy.

关 键 词：颈椎 脊柱后凸 畸形 纳米羟基磷灰/聚酰胺66人工椎体 

分 类 号：R687.3[医药卫生—骨科学]