经椎弓根颈椎后路内固定的应用分析

Application of Screw-rod System in Posterior Cervical Fixation

目的:探讨经椎弓根螺钉-棒系统行颈椎后路内固定在治疗颈椎疾病中的可行性及优越性。方法:2007年2月-2009年10月,应用经椎弓根颈椎螺钉-棒系统行颈椎后路内固定治疗各种颈椎疾患15例,其中颈椎管肿瘤3例,多节段脊髓型颈椎病并不稳2例,高位颈椎损伤并不稳3例,下颈椎骨折脱位7例,均伴不同程度的脊髓损害。结果:共经颈椎弓根植入78枚多轴螺钉,无硬膜撕裂、椎动脉损伤与脊髓损伤等并发症。平均随访13个月,所有患者内固定满意,无螺钉拔出、内固定松动、复位丢失,均获得骨性融合。神经功能均有不同程度恢复,JOA评分平均恢复率为40.6%。结论:经椎弓根颈椎螺钉-棒系统后路固定颈椎安全可靠,有利于植骨融合及术后生理曲度的维持,临床效果满意。

Objective：To explore the outcomes of posterior cervical fixation using screw-rod system through pedicle of vertebral arch.Methods：From February of 2007 to October of 2009,fifteen patients were cured by the method.They comprised three with spinal canal tumor,two with cervical spondylotic myelopathy and instability,three with traumatic of higher cervical and instability,and seven with lower cervical fracture and dislocation.All had neural defects in different degrees.Results：A total of 78 screws were implanted.No cerebrospinal fluid leakage,spinal cord or vertebral artery injury occurred.Thirteen patients were followed up with for 13 months on average.All patients had satisfactory fixation and got firm fusion.No back-out of screw,loosing of fixation,and loss of reduction occurred.All had neurological recovery and the improvement rate of JOA score of the neural function was 40.6 %.Conclusion：The data indicate that posterior cervical fixation using screw-rod system through pedicle of vertebral arch is safe and reliable with the satisfactory clinical outcome.