异体骨椎间融合器在颈椎前路融合术中的应用价值

The application of allograft interbody fusion cage to anterior cervical spine interbody fusion

目的 探讨螺纹异体骨椎间融合支架 (allograftinterbodyfusioncage ,AIFC)在颈椎前融合术中的应用价值。方法 自 1998年 6月～ 2 0 0 0年 6月 ,采用AIFC行颈椎前路融合术 90例 ,其中男 35例 ,女 5 5例 ,年龄 37～ 72岁 ,平均4 7岁 ,其中神经根型颈椎病 5 6例 ,脊髓型颈椎病 32例 ,椎动脉型颈椎病 2例。采用颈前横行切口 ,C臂X线透视定位病变间隙 ,行环钻前路减压 ,AIFC植入融合固定。术后随访观察AIFC的融合率 ,椎间高度维持情况及有无并发症。结果 76例获得良好随访 ,随访时间 18个月～ 3年 ,平均 2 6个月 ,术后 3d、1、3、6、9、12、18、2 4个月常规X线片检查 ,74例获得骨性融合 ,融合率为 97.3% ,椎间高度维持良好 ,AIFC无移位 ,2例成角畸形愈合 ,颈椎呈后凸畸形。结论 AIFC具有良好的维持椎间高度功能 ,抗压缩、抗旋转 ,稳定性好 ,椎间融合率高 ,符合颈椎生物力学及临床要求。

Objective To discuss the value of using allograft interbody fusion cage (AIFC) for anterior cervical spine interbody fusion.Methods From June 1998 to June 2000,ninety patients involving cervical diseases were treated by anterior decompression and AIFC graft.There are 35 males and 55 females with the age ranged from 37 to 72,being 47 years old in average.56 cases of cervical radicalopathy,32 cases of cervical spondylotic myelopothy,2 cases of cervical spondylotic arteriopathy were included in the data.To determine the location of pathological disc under the fluoroscope of the'C'arm Xray, then inserted the AIFC into the interspace of cervical spine through the transverses incision of anterior cervical. The AIFC fusion rate,the maintenance of intervetebral height,and the complications of the hardware were observed. 76 cases were followedup, ranging from 18 months to 3 years after postoperation,with the average of 26 months. The Xray photographes were taken 3 days after operation and followed with one month, 3, 6, 9,12,18 and 24 months.Results Solid fusion were obtained in 74 cases with the fusion rate being 97.3%; the intervetebral height were maintained. There were no displacement of AIFC.Two cases suffered from angulation fusion,and the cervical spine became back evagination.Conclusion The AIFC could maintain the height of intervertebral space and in support of anticompression and anticonvolution.The fusion rate is satisfactory,that it completely meets the clinical and biomechical requirements.