摘要
目的探讨单嵌片自稳型颈椎融合器在颈椎前路减压融合术中的应用,报告5年随访疗效。方法选取47例因脊髓型或神经根型颈椎病行颈椎前路减压+单嵌片自稳型颈椎融合器置入术患者。侧位X线片观察椎间高度、颈椎前凸角及植骨融合率;术前及术后进行JOA评分,观察神经功能恢复情况;VAS评分评价患者颈部或肢体疼痛;SF-36健康调查评分观察临床疗效。结果术后6个月67个融合节段均获骨性融合。椎间隙高度术前为(4.47±0.86)mm,末次随访为(7.41±0.72)mm。颈椎前凸角术前为(0.7±4.1)°,末次随访为(5.9±3.6)°。随访56~96个月,所有患者未出现严重手术并发症,神经功能有明显恢复。JOA评分由术前(9.15±0.22)分增至末次随访(14.89±0.16)分,VAS评分由术前(5.24±1.44)分减至末次随访(0.35±0.49)分。JOA及VAS评分术前较术后各次随访具有统计学差异(P<0.05),但术后各次随访之间无统计学差异(P>0.05)。SF-36健康调查评分6个维度,术前及术后评分均具有统计学差异(P<0.05)。结论单嵌片自稳型颈椎融合器能使融合节段获得即刻稳定性,有效恢复和维持椎间隙高度,植骨融合率高,中远期疗效好,适用于多种需前路减压的颈椎退变性疾病。
Objective To investigate the feasibility and application of stand-alone MC+polyether-ether-ketone(PEEK)Cage used in the anterior cervical discectomy and fusion(ACDF)and observe the clinical effectiveness of 5 years follow-up.Methods Forty-seven patients treated by ACDF for cervical spondylotic myelopathy or cervical spondylotic radiculopathy were collected.The height of intervertebral space,cervical lordosis angle and fusion rate were observed by lateral X-ray film.The Japanese Orthopedic Association score(JOA)was performed to assess the recovery of neurofunctional condition.The visual analogue scale(VAS)was used to evaluate neck or limbs pain,while the SF-36 Health Survey scores were used to evaluate the quality of life of patients after operation.Results The bone graft fusion rate in 67 operative segments was 100%.The height of intervertebral space was(4.47±0.86)mm before operation and(7.41±0.72)mm at last follow-up.The C2~C7 Cobb’s angle was(0.7±4.1)°before surgery,and(5.9±3.6)°at last follow-up.All patients were followed up for 56~96 months,in which time these patients did not have serious surgical complications,and the neurological function recovered significantly.The JOA score increased from(9.15±0.22)points before the operation to(14.89±0.16)points in the last follow-up.The VAS score in the pre-operative and the last follow-up was(5.24±1.44)points and(0.35±0.49)points respectively.There were statistical differences in the JOA score and VAS score between preoperative and postoperative(P<0.05),but there were no statistical differences between each postoperative follow-up(P>0.05).There were statistical differences between the preoperative and postoperative of SF-36 Health Survey scores on six items(P<0.05).Conclusions The stand-alone MC+polyether-ether-ketone(PEEK)Cage has a unique design of selfanchoring and immediate stability,effectively restore and maintain intervertebral height,with high bone graft fusion rate and good medium and long-term efficacy.It is suitable for a variety of cervical degenerative diseases which requiring anterior decompression.
作者
闫慧博
邓尚希
黎庆初
金大地
刘则征
程亮
江剑
Yan Huibo;Deng Shangxi;Li Qingchu;Jin Dadi;Liu Zezheng;Cheng Liang;Jiang Jian(Department of Spine Surgery,The Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China)
出处
《中国临床解剖学杂志》
CSCD
北大核心
2021年第5期603-608,共6页
Chinese Journal of Clinical Anatomy
关键词
颈椎病
椎间植骨融合术
单嵌片自稳型颈椎融合器
Cervical spondylosis
Interbody fusion
Stand-alone MC+polyether-ether-ketone(PEEK)Cage
作者简介
闫慧博(1975-),医学博士,副主任医师,研究方向:脊柱外科,E-mail:yhb2096@163.com;通信作者:江剑,医学博士,E-mail:465367365@qq.com。
