同种异体骨在脊髓型颈椎病椎体次全切除减压融合术中的应用

The efficacy of allogenic strut bone graft and instrumentation for anterior cervical fusion following subtotal corpectomy and decompression in cervical myelopathy

目的 评价同种异体骨联合前路钢板在脊髓型颈椎病椎体次全切除减压融合术中的应用效果。方法 对 35例颈脊髓病患者行颈前路椎体次全切 ,同种异体骨植入联合前路钢板内固定并分析其结果。术前JOA评分 4～ 15分 ,平均 8 7分。结果 本组 35例患者 ,次全切除椎体 6 9个 ,其中单椎体次全切 7例 ,双椎体 2 2例 ,三椎体 6例 ,完成减压 10 4个间隙 ,无手术并发症。随访时间 11～ 37个月 ,平均 17 4个月。术后植骨稳定 ,未发现钢板、螺钉松动、断裂等现象 ,植骨融合率10 0 % ;融合时间约 6～ 15个月 ,平均 9 3个月 ;术后JOA评分 7～ 17分 ,平均 14 8分 ,改善率为73 5 % ,优良率为 82 8%。结论 在颈脊髓病椎体次全切减压术中 ,使用同种异体骨结合颈前路钢板进行融合和固定可以简化手术步骤、减少创伤 ,且融合可靠。

Objective To evaluate the efficacy of allogenic strut bone graft and instrumentation for anterior cervical fusion following subtotal corpectomy and decompression in cervical myelopathy. Methods Thirtyfive patients with cervical myelopathy were treated by the procedure of allogenic strut bone graft and instrumentation for anterior cervical fusion following subtotal corpectomy and decompression. The preoperative average JOA scale score was 8.7 point (Range 415). Results Sixtynine vertebral were corpectomized and 104 levels were decompressed and fused with an average of 3 levels. Among the cases,1 vertebrae was corpectomized in 7 cases, 2 vertebra in 22 cases,3 vertebra in 6 cases. There were no surgeryrelated complications. The patients were followed up from 1137 months , with an average of 17.4 months. No plate breakage, screw loose, graft infection, lysis and absorption was discovered. The fusion rate was 100%, the average time of fusion was 9.3 months(range from 615 months) .The postoperative average JOA scale score was 14.8 point (range 717), the recovery ratio was 73.5% and the excellent and good results was 82.8%.Conclusions The use of allogenic strut bone graft and instrumentation for anterior cervical fusion following subtotal corpectomy and decompression in cervical myelopathy may not only simplify surgical procedure and decrease injuries and complications,but also the fusion is satisfactory and reliable.