颈前路减压PEEK融合器加钢板内固定治疗颈椎病

Anterior cervical discectomy and fusion with plate and polyetheretherketone(PEEK) cage for degenerative cervical spinal disorders

目的探讨颈前路减压PEEK融合器加钢板内固定治疗颈椎病的临床疗效。方法采用颈前路减压PEEK融合器加钢板内固定治疗20例颈椎病患者。结果患者均获随访,时间18-36个月。术后早期四肢运动功能恢复较好,感觉障碍恢复较慢;术前肌张力高者术后肌张力下降;患者肢体灵活性改善。骨性融合时间为10-15周,有2例出现塌陷,分别为2.4 mm与2.8 mm。JOA评分术前为6-11分,术后为12.2-13.4分。病变椎间隙高度术前为5.8-7.5mm,术后为7.8-9.6 mm。颈椎功能障碍指数术前、术后2周及末次随访时分别为51%-60%、20%-26%、14%-18%。按Robinson et al临床疗效分级：优15例,良3例,差2例。患者颈椎前凸术前为4.8°-6.3°,术后为16.8°-18.2°,末次随访时为14.6°-17.8°。结论颈前路减压PEEK融合器加钢板内固定治疗颈椎退变性疾病,假关节及邻近节段的退变发生率较低,是治疗颈椎病安全有效的方法。

Objective To evaluate the clinical efficacy of anterior cervical discectomy and fusion with plate and polyetheretherketone（PEEK） cage for degenerative cervical spinal disorders.Methods The clinical outcomes of 20 patients who received the treatment of anterior cervical discectomy and fusion with plate and PEEK cage were analyzed.Results All patients were followed up for 18-36 months.The recovery of extremities motor function was better than that of sensory function at the early stage after operation.Muscular tension decreased after operation and mobility of limbs was improved.Radiological solid fusion was observed at 10 to 15 weeks after surgery,and there was cage subsidence in 2 patients.The JOA score before surgery and postoperative was 6 to 11 and 12.2 to 13.4 respectively.The mean anterior interspace height before surgery and postoperative was 5.8 to 7.5mm and 7.8 to 9.6 mm respectively.The NDI before surgery,second postoperative week and at the last follow-up was 51% to 60%,20% to 26% and 14% to 18% respectively.According to Robinson et al clinical classification,excellent result was achieved in 15 cases,good in 3 cases and poor in 2 cases.The average angle of cervical lordosis 4.8° to 6.3° preoperatively,16.8°to 18.2° postoperatively and 14.6°to 17.8° at the last follow-up.Conclusions For patients with degenerative cervical spinal disorders,anterior cervical discectomy and fusion with plate and PEEK cage reduces the pseudarthrosis and adjacent segment degeneration and improves the clinical outcomes.This method is considered to be a relatively safe and effective treatment modality.