颈椎椎体次全切除钛网钉板系统的临床应用

Clinical application of titanium mesh cage combined with screw-plate system in cervical spine subtotal corpectomy

目的探讨颈椎前路椎体次全切除钛网钉板植骨融合的临床效果.方法自2001年3月～2003年3月间应用颈前路椎体次全切除钛网植骨融合及钉板固定治疗颈椎管狭窄性疾病22例,其中4例患者行2椎体次全切除3节椎间隙减压手术.术后观察减压、固定、融合及神经功能恢复情况,并行X线摄片或CT扫描检查.结果患者获6～12个月随访,神经功能得到不同程度改善,无加重情况.椎间隙高度无丢失、无成角,均获得骨性融合.术后3 d在颈围领固定下下床活动,4周后可恢复较轻工作.结论此术式可避免传统手术方法的缺点,即不取自体髂骨,融合率高,稳定性好,并减压彻底,疗效好,是一种值得推广的新技术.

Objective To explore the clinical effect on bone graft fusion through anterior approach for cervical spine subtotal corpectomy by titanium mesh cage combined with screw-plate system. Methods From March 2001 to March 2003, 22 cases with cervical spinal stenosis were treated with iliac crest auto-graft by titanium mesh cage and screw-plate through anterior approach for cervical spine subtotal corpectomy, including 4 cases undergoing vertebral subtotal corpectomy in 2 and intervertebral space decompression in 3. Physical, X-ray and CT examinations were taken at regular interval postoperatively to assess the recovery of nervous function, anterior decompression, cervical stability and bony fusion. Results A follow-up was taken to these cases for 6 to 12 months. The nervous functions were recovered in different levels without deterioration; intervertebral space had no decrease on its height and no angulation. The patient fixed with collar after operation could get out of bed in 3 days and do light work in 4 weeks. All cases acquired bony fusion. Conclusion Titanium mesh cage combined with screw-plate system for cervical spine subtotal corpectomy has advantages of less trauma for graft, good stability, higher fusion rate, full decompression, satisfactory clinical effect by the traditional ways. Therefore, this operative method is a new technique and deserved to the further application in clinic.