3D打印人工椎体联合PEEK-Cage置入治疗颈椎后纵韧带骨化症短期疗效分析  

Short-term efficacy of 3D-printed artificial vertebral body combined with PEEK-Cage implantation in treatment of ossification of posterior longitudinal ligament of cervical spine

作　　者：孙绍铜 刘军 刘莛予 任伟剑 SUN Shao-tong;LIU Jun;LIU Ting-yu;REN Wei-jian(Fifth Department of Orthopaedics,Liaoning Provincial People's Hospital,Shenyang Liaoning 110000,China)

机构地区：[1]辽宁省人民医院骨五科,辽宁沈阳110000

出　　处：《局解手术学杂志》2025年第4期325-329,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨颈椎前路3D打印人工椎体联合PEEK-Cage置入手术治疗颈椎后纵韧带骨化症(OPLL)的短期疗效。方法回顾性分析2022年9月至2023年6月在辽宁省人民医院骨五科接受颈椎前路3D打印人工椎体联合PEEK-Cage置入手术治疗的15例OPLL患者的临床资料。分析患者手术时间、术中失血量、术后引流量、卧床时间、住院时间及手术相关并发症情况。统计患者术前、术后3 d、术后1个月以及术后6个月日本骨科协会(JOA)评分、视觉模拟量表(VAS)评分。统计患者术前、术后3 d、术后1个月和术后6个月融合节段的Cobb角变化情况。结果15例患者均顺利完成手术,手术时间130~160 min,平均(148.68±10.04)min;术中出血量50~200 mL,平均(130.0±18.8)mL;术后引流量220~980 mL,平均(270.0±24.6)mL;卧床时间3~11 d,平均(3.6±2.8)d;住院时间7~16 d,平均(8.2±2.6)d。所有患者切口均Ⅰ期愈合,未出现感染。1例患者术中发生硬膜囊撕裂;4例患者术后出现吞咽困难;1例患者术后出现一侧肢体肌力减退;1例患者术后3 d颈椎手术切口内血肿形成。术后3 d、术后1个月和术后6个月,3例存在髓性症状伴上肢根性痛患者的Cobb角、VAS评分及JOA评分均较术前明显改善(P<0.05),12例仅存髓性症状患者的Cobb角及JOA评分均较术前明显改善(P<0.05)。结论颈椎前路3D打印人工椎体联合PEEK-Cage置入是治疗OPLL的一种有效方法,能在短期内显著缓解患者的疼痛,改善功能障碍,具有良好的稳定性和融合效果。Objective To investigate the short-term efficacy of 3D-printed artificial vertebral body combined with PEEK-Cage implantation in anterior cervical surgery for ossification of the posterior longitudinal ligament of the cervical spine(OPLL).Methods The clinical data of 15 patients with OPLL who underwent anterior cervical surgery with 3D-printed artificial vertebral body and PEEK-Cage implantation in the Fifth Department of Orthopaedics,Liaoning Provincial People´s Hospital from September 2022 to June 2023 was retrospectively analyzed.The surgical time,intraoperative blood loss,postoperative drainage volume,bed rest time,hospital stay,and surgery-related complications of patients were analyzed.The Japanese Orthopaedic Association(JOA)score and visual analogue scale(VAS)score of patients were counted before surgery,3 days after surgery,1 month after surgery and 6 months after surgery.The changes of Cobb angle of fusion segment of patients were recorded before surgery,3 days after surgery,1 month after surgery and 6 months after surgery.Results All 15 patients successfully completed the surgery.The surgical time was 130 to 160 minutes,with an average of(148.68±10.04)minutes.The intraoperative blood loss was 50 to 200 mL,with an average of(130.0±18.8)mL.The postoperative drainage volume was 220 to 980 mL,with an average of(270.0±24.6)mL.The bed rest time was 3 to 11 days,with an average of(3.6±2.8)days.The hospital stay was 7 to 16 days,with an average of(8.2±2.6)days.All patients´incisions healed in the first stage,and no infection occurred.One patient suffered from dural sac tear during surgery;4 patients had dysphagia after surgery;1 patient suffered from muscle weakness of one limb after surgery;Hematoma formed in the incision of cervical spine in 1 patient 3 days after surgery.At 3 days,1 month,and 6 months after surgery,the Cobb angle,VAS score and JOA score of 3 patients with myeloid symptoms and upper limb root pain were significantly improved compared with those before surgery(P<0.05),and the Cobb angl

关 键 词：人工椎体 颈椎前路融合术 PEEK-Cage 颈椎后纵韧带骨化症 

分 类 号：R681.5[医药卫生—骨科学]