钛网联合颈椎锁定钢板技术在颈椎前路融合中的应用

Cylindrical titanium mesh and cervical locking plates in anterior cervical fusion

目的 :评价钛网联合颈椎前路锁定钢板系统替代技术进行颈椎前路融合 ,维持颈椎生理前凸的临床效果。方法 :对 2 8例颈椎疾患病人进行前路颈椎次全切 (或颈椎间盘切除 )、椎管减压、钛网内添自体松质骨椎间融合、颈椎前路钢板锁定系统内固定手术 ,并评定疗效和进行影像学分析。结果 :患者平均住院天数 5 (4～ 6 )d ,所有病人的神经症状术后得到不同程度的恢复 ;术后影像学资料提示钢板位置良好 ,无钛网脱出 ;术后随访时间 11.8(6～ 18)月 ,所有病人获得了颈椎间融合 ,固定节段区的整体生理前凸平均改变 1.3°,后凸平均改变 0 .2°。结论 :钛网植骨可以避免取髂骨所带来的并发症 ,联合颈椎前路锁定钢板系统替代技术可以有效地进行颈椎前路融合和维持颈椎生理曲度。

Objective To evaluate the clinical effect of a cylindrical titanium mesh and locking plate system as an alternative technique in achieving good anterior cervical fusion and maintaining lordosis. Methods Twenty eight patients who underwent anterior cervical corpectomies(or discectomies), decompression, titanium mesh cage filled with local autologous bone graft, and cervical locking plate fixation were evaluated. Results The average in patient days were 5 (4～6)d . No donor bone site complications occurred. All patients returned their neurological symptoms to some degree. The titanium mesh and locking plate were not loosened. All the patients were followed up for 11.8 (6～18 ) months. The complete fusion of bone graft was observed in all the patients. The mean change in overall lordosis related to the fixation was 1.3°, and the average change in kyphosis was 0.2°. Conclusion Titanium mesh cage filled with autologous bone graft can avoid the complications of donor bone site,and shorten the hospital stay. When combined with cervical anterior locking plate, it can obtain a satisfactory clinical results.