纳米羟基磷灰石/聚酰胺66复合人工椎体在颈椎前路减压融合术中的应用

A comparison between artificial vertebra by n-HA/PA66 and iliac crest autograft in anterior cervical decompression and fusion

目的探讨纳米羟基磷灰石/聚酰胺66(n-HA/PA66)复合人工椎体在颈椎前路减压融合术中恢复、维持颈椎曲度及椎间高度的效果。方法对38例颈椎病患者采用颈椎前路减压融合术,20例行n-HA/PA66复合人工椎体植骨(A组),18例行自体髂骨植骨(B组)。比较两组植骨融合情况、融合节段椎间高度及Cobb角。结果两组均经6～15个月随访,均获植骨融合。术后3个月相对于术后1周融合节段椎体后缘高度及Cobb角改变,两组差异均有统计学意义(<0.05);3个月后椎间高度变化均较小,两组比较差异无统计学意义(>0.05)。结论 n-HA/PA66复合人工椎体在维持椎体后缘高度和融合节段曲度方面均优于自体髂骨,且较快达到骨性融合。

Objective To study the stability of reconstructing cervical vertebrae with artificial vertebra by n-HA/PA66 and iliac crest autograft in anterior cervical decompression and fusion（ACDF）.Methods 68 cases of cervical spondylotic myelopathy（CSM）treated with ACDF,20 cases with artificial vertebra by n-HA/PA66 and dynamic plate（ABC,Aesculap,Germany）,18 cases with iliac crest autograft and the same plate.Preoperative,1-week-after-operation and the follow-up radiographs were taken.The interverberal height,the Cobb＇s angle and the curve of cervical spine were observed,and the data were compared statistically with the two-sample t-test check.Results All the patients were followed up from 6 to 15 months.The grafting bones were fusioned in all patients.Interverteberal height and Cobb＇s angle changes from 3 months to 1 week after operation,and 3 months after operation,there were differences between two groups（P〈0.05）.Conclusions The two materials cause effectively reconstructed and keep it the stability of cervical vertebrae.The artificial vertebra by n-HA/PA66 is much better than iliac crest autograft in restoring interverteberal posterior height and cervical physiological curvature.The average period of time in achieving fusion of artificial vertebra is longer than that of iliac crest autograft.