颈椎前路融合术后假关节形成对疗效的影响

Clinical observation of pseudarthrosis after anterior cervical fusion

目的:观察颈椎前路减压融合术后假关节形成对神经功能和颈部症状的影响。方法:对109例颈椎前路减压融合术后患者进行平均11.1年的随访,常规拍摄颈椎屈伸侧位X线片,判断是否有假关节出现。采用JOA17分法对手术前后的神经功能进行评定,观察术后患者的颈部症状并进行分级。对部分资料进行统计学分析。结果:109例患者的假关节发生率为26.61%(29/109),单节段融合无假关节发生,而4节段融合的假关节发生率为36.36%。术后平均神经功能改善率为68.49%,颈部症状的发生率为35.78%。有假关节者与无假关节者比较,其神经功能改善率的差异有显著性意义(P<0.05),其颈部症状发生率相近。结论:假关节形成是颈椎前路手术后的常见远期并发症,其发生率与融合节段的多少有关。假关节形成可对术后远期神经功能恢复造成影响,但与患者术后颈部症状的发生无明显相关性。

Objective：Observing the influence of pseudarthrosis to the neurological function and neck symptoms after anterior cervical fusion.Method：109 cases who accepted anterior cervical fusion were followed up with an average of 11.1 years.The neurological function was judged by using JOA grading system before and after operation.The neck symptoms were observed and graded at each follow-up visit.Pseudarthrosis was evaluated by means of flexion-extension X-rays.Some data was analysis by statistics.Result：The incidence of pseudarthrosis was 26.61%.There was no pseudarthrosis in the single-level fusion,and 36.36% pseudarthrosis was found in four-level fusion.The average neurological function improved 68.49%,and the average neck symptoms happened in 35.78% of patients.The improvement rate of neurological function was lower in cases who had pseudarthrosis compared with those without pseudarthrosis.The incidence of neck symptoms was similar in two groups.Conclusion：Pseudarthrosis is a frequent long-term complication after anterior cervical fusion.The incidence is related to the fusion range.Pseudarthrosis has bad influence to the long-term recovery of neurological function after operation ,but is not related significantly to the neck symptoms.