纳米羟基磷灰石/聚酰胺66复合人工椎体在颈椎病前路椎体次全切除术中的临床应用

Clinical application of anterior cervical subtotal corpectomy and fusion with n-HA/PA66 composite artificial vertebral body for cervical spondylosis

目的探讨纳米羟基磷灰石／聚酰胺66（n—HMPA66）复合人工椎体在颈椎前路次全切除术中应用的短中期临床疗效。方法自2008年5月～2009年6月对44例脊髓型颈椎病行前路椎体次全切除、椎管减压、n—HA/PA66复合人工椎体植骨融合＋钢板内固定术治疗，以JOA评分改善率评价神经功能恢复情况，并依据X线片判断椎间稳定性和融合情况。结果本组无术中并发症，伤口均一期愈合。患者获随访12～26个月，平均18个月，症状均明显改善，JOA评分由术前（6．4±1．8）分提高到术后（15．2±1．5）分，JOA改善率83．0％，优良率86．4％，问卷调查满意度97．6％。X线检查证实无人工椎体移位、下沉，融合率100％。结论n—HA/PA66复合人工椎体具有良好的生物相容性及安全性。是一种较理想的骨移植材料，适用于颈椎病前路次全切除术中。

Objective To evaluate the short and mid-term clinical effect of anterior cervical subtotal corpectomy and fusion with n-HAIPA66 composite artificial vertebral body for cervical spondylosis. Methods From may 2008 to June 2009, 44 patients with cervical spondylosis received anterior cervical subtotal corpectomy, spinal canal decompression and reconstruction by n-HA/PA66 composite artificial vertebral body combined with plate instrumentation. Neurological function was assessed by improvement rate of JOA score, and roentgenograms was analyzed to identify the stability of the fused level. Results In all patients, no complications occurred during operation. Wounds were normally healed without acute or chronic infection. All patients were followed up for 12 to 26 months, with an average of 18 months. Preoperative symptoms were all improved in patients, the mean JOA scores was （6.4：t：1.8） preoperatively and improved to （15.2±1.5） at final follow-up, JOA improvement rate was 83.0%, the excellent and good rate was 85.7%, patients of 97.6% were satisfied with this procedure. The X-ray films demonstrated that no artificial vertebral body was found displacing or subsiding, all patients got bone fusion. Conclusion Anterior cervical subtotal corpoctemy and fusion with n-HA/PA66 composite artificial vertebral body have a satisfatory short and mid-term clinical effect for cervical spondylosis, and it can provide immediate biomechaninical stability, restore intervetebral height and lordosis, shorten operation time, and avoid complications in the donor site.