前路钢板对两节段颈椎间植骨的运用价值

The values of anterior locking plate in two-level cervical discectomy and intervertabral graft

目的评价前路钢板对两节段颈椎间植骨融合的影响。方法46例两节段颈椎病患者,环锯法切除椎间盘、自体髂骨植骨,其中26例病人用了前路钢板内固定。术后复查X线片,了解植骨融合情况,并评价临床效果。结果26例运用钢板患者,全部获得骨性融合;20例单纯植骨病人,4例出现(20%)假关节,融合节段前凸丢失的度数较植骨融合组明显增大。获得植骨融合的病人,临床结果相似(P>0.05)。结论前路钢板系统增加两节段颈椎间植骨融合率、减少并发症。

Objective To evaluate the effect of anterior cervical plate fixati on on the clinical and radiographic success of two-level discectomy,intervertabr al graft. Methods During recent four years, 46 cervical spondylotic myelopathy patients(aged at 31-69 years old,mean 46.6 years old),28 men,18 women,were follo wed up after operation for 6-24 months,average 15.7m. All disc materials were re moved with Smith-Robinson means,and autogenous iliac crest bone graft was placed into the disc space. Of the 48 patients,26 patients had anterior cervical plate s. A radiograph was taken at 2 and 6 weeks after surgery,and then at monthly int ervals until the fusion was solid or pseudarthorsis presented. Clinical follow- up evaluations were performed by Odom's criteria. Results All twenty-six patien ts with cervical plates had fusions. Of the twenty patients without plates,4 pat ients had pseudarthrosis. The amount of cervical lordosis loss is larger as comp ared with those without a plate who developed a pseudarthrosis(P<0.05). Accordin g to Odom's criteria,the result of the surgeries of 28 patients using a plate is as follow:excellent40%(11),good 52%(15),fair 8%(2),poor 0,while the outcome of 20 patients without plates is 35%(7),55%(11),5%(1),5%(1)(P>0.05). Conclusions T he addition of plate fixation for two-level anterior cervical discectomy can inc rease fusion and decrease the complication rate. The results in patients with pl ates are markedly similar to those in patients who fused without plates.