颈前路自锁式椎间融合器治疗多节段颈椎病的早期疗效分析

Clinical outcomes of anterior cervical discectomy and self-locking cage fusion in treating the multilevel cervical spondylosis

目的分析采用颈前路自锁式椎间融合器治疗多节段颈椎病的早期临床疗效及影像学评估。方法 2011-10-2012-10多节段颈椎病患者46例接受颈前路减压自锁式椎间融合器植骨融合术。2节段23例,3节段21例,4节段2例。共植入MC+椎间融合器117枚。术前和术后1、3、6个月对患者行VAS评分、JOA17分法评分、NDI评定。根据术前术后颈椎侧位及屈伸位X线片上测量颈椎曲度、椎间隙高度,观察手术间隙融合及相邻节段退变情况。结果随访期间手术间隙无异常活动,融合器无移位、下沉与断裂。术后1、3、6个月,VAS评分低于术前6.5±1.3分(P<0.05);JOA评分高于术前7.9±1.6分(P<0.05);NDI评分低于术前42±13.6分(P<0.05);颈椎曲度大于术前8.0±8.2°;椎间隙高度均大于术前5.4±1.3mm。结论颈前路自锁式椎间融合器治疗多节段颈椎病的早期疗效满意,稳定性可靠,能重建颈椎曲度并维持椎间隙高度。

Objective To evaluate the clinical effect and radiologic outcomes of the multilevel cervical spondylosis treated through anterior cervical discectomy and self-locking cage fusion.Methods From Oct 2011 to Oct 2012,46 patients with multilevel cervical spondylosis underwent the anterior cervical discectomy and self-locking cage fusion.23cases underwent 2-level,21cases were 3-level and 2 cases were 4-level.The total of 117 MC＋cages were implanted.VAS,JOA 17 score and NDI were evaluated pre-and-postoperatively.Lateral and flexion,extension cervical Xrays were obtained in the standing position before surgery and postoperative intervals of 1,3,6 months.The sagittal segmental alignment of cervical spine（C2-7） and the height of inter-vertebrae space were measured before and after surgery.According to the radiographs,adjacent segment degeneration and fusion rates were observed.Results There was no abnormal activity in the surgical segment and any cages moved,sunken or broken during the follow-up.1,3,6 months after operation,VAS scores were significantly lower than preoperative VAS score 6.5±1.3（P＆lt;0.05）;JOA scores were significantly higher than preoperative JOA score 7.9±1.6（P＆lt;0.05）;NDI scores were significantly lower than preoperatively 42±13.6（P＆lt;0.05）.The sagittal segmental alignment of cervical spine significantly increased compared with preoperatively 8.0±8.2° and the height of inter-vertebrae significantly increased than preoperatively 5.4±1.3mm.Conclusion The early outcomes of the multilevel cervical spondylosis treated through the anterior cervical discectomy and self-locking cage fusion is satisfactory and reliable.It can also restore the cervical alignment and maintain the height of inter-vertebrae.