榫状植骨在颈椎前路手术中的应用

Application of tenon shaped bone graft in the anterior approach operation of cervical spine

目的：在颈椎前路减压手术中采用榫状植骨，以取得更好的植骨效果。方法：８６例采用环锯法完成相应颈椎节段前路扩大减压，２或３个间隙者，去除两减压孔间的椎体骨，沟通成一长槽，在槽两端的椎体边缘中部各开一个小凹槽。取自体髂骨或同种异体骨制成榫状，使榫状植骨块的突出榫部正好卡在上述小凹槽中。术后用皮革颈围领或石膏颈围领固定。结果：随访０．５～８年，平均４．５年，均无植骨块移位、脱出或陷入，一般在术后２～３个月内植骨完全融合。结论：榫状骨块卡入牢固，增加了骨块的抗旋转与屈伸应力；在术中击入植骨块时或术后，该榫状植骨块不会陷入压迫脊髓，且植骨愈合较快。

Objective:To get better result of graft,tenon shaped bone graft was designed.Method:Tenon shaped bone graft during anterior decompression of cervical spine were used in 86 cases.In the cases of 2 or 3 vertebral intervals,removed the vertebral bone between two decompression holes,and link up through the holes to form a long trough after anterior extended decompression of cervical spine by a ring saw.A small concave groove was made at the middle part of the vertebral edges on the both ends of the trough respectively.Tenoned on the autoiliac or alloiliac bone and put it into the trough.Then the tenons were set in the grooves.The neck was fixed with leather collar of plaster cast after the operation.Result:The period of postoperative follow up studies varied from 0 5 to 8 years with an average of 4 5 years.There is no motility and separation or falling of the tenon shaped bone in all cases.The bone graft healed 2 to 3 months after the operation.Conclusion:The tenon shaped bone graft is firm.The bone tenon was inlaid well.It increased its rotative resistance and extension and flexion resistance.When the bone is put into the trough and then,it does not fall and compresse the spinal cord.The bone graft healted quickly. Authors address\ Department of Orthopaedics,The First Affiliated Hospital of Henan Medical Universidy,Zhengzhou,Henan450052