钛网植骨联合颈前路钢板治疗多节段颈椎病的临床应用

The clinical application of titanium mesh and bone graft combining with anterior titanium plate in treatment of the multilevel cervical spondylosis after anterior cervical corpectomy

目的探讨钛网植骨联合颈前路钢板在治疗多节段颈椎病中的临床应用价值。方法回顾性分析新疆医科大学第一附属医院脊柱外科2003年6月～2006年6月40例行颈椎前路减压钛网植骨颈前路钢板固定治疗多节段颈椎病患者的临床资料。病变累及单椎体两间隙16例,两椎体三间隙19例,三椎体四间隙5例。侧位颈椎X线片测定颈椎曲度"D"值,JOA评分法评定颈脊髓神经功能,并对结果进行分析。结果全部资料均获随访,次全切除颈椎体69个,切除病变椎间盘109个,颈椎曲度"D"值由术前的(4.3±2.1)mm提高到术后的(9.2±2.5)mm,JOA评分由术前的(9.6±2.1)分增加到术后的(13.1±1.9)分,平均增加4.4分,差异有统计学意义(P<0.05)。其中7例发生钛网下沉,钛网下沉发生率为17.5%(7/40)。结论钛网植骨联合颈前路钢板治疗多节段颈椎病,可使施术节段得到支撑和稳定,近期疗效满意,提高了临床改善率,但要重视钛网下沉等并发症。

Objective To explore the clinical application of titanium mesh and bone graft combining with anterior locking titanium plate in treatment of the multilevel cervical spondylosis after anterior cervical corpectomy.Methods Totally forty cases from June 2003~June 2006 in our department with multilevel cervical spondylosis were retrospectively operated and re-constructive by titanium mesh and bone graft combining with anterior titanium plate.69 cervical vertebral and 109 inter-vertebral spaces were cut,among of them,there were 16 cases with single vertebral and two inter-vertebral spaces,19 cases with two vertebral and three inter-vertebral spaces,5 cases with three vertebral and four single vertebral and two inter-vertebral spaces,19 cases with two vertebral and three inter-vertebral spaces,5 cases with three vertebral and four inter-vertebral spaces.Lords of cervical spine with D numerical value were measured,according to JOA score,the neurological functions were calculated respectively between pre-operative and post-operative scores,the data was compared statistically with student＇s t-test.Results All cases were regularly followed up.Lords of cervical spine with D numerical value was increased from pre-operation（4.3±2.1）mm to post-operation（9.2±2.5）mm,the scores of JOA average increased 4.4 scores from pre-operation（9.6±2.1）to post-operation（13.1±1.9）.There was 7 cases appeared to the subsidence of titanium mesh,the rate subsidence of titanium mesh was 17.5%（7/40 cases）.Conclusion Titanium mesh and bone graft combining with anterior locking titanium plate treating for the multilevel cervical spondylosis after anterior cervical corpectomy is able to raise the clinical improvement rate,and think highly of the subsidence of titanium mesh its complications.