颈椎术后钛网沉陷的影像学表现及相关影响因素

Imaging and Related Factors of Subsidence of Titanium Mesh Cage after Cervical Spine Surgery

目的探讨颈椎钛网植骨融合术后早期钛网沉陷的影像学表现及其相关影响因素。方法收集58例颈椎钛网植骨融合术术后1周、术后3月X线片及临床资料进行观察、分析。结果本组发生钛网沉陷31例(53.4%),其表现为钛网进入上位或/和下位椎体骨质内,以钛网后下部沉陷进入下位椎体多见;螺钉与钛板夹角变小。钛网沉陷的发生率在性别方面,差异无显著性(P=0.875);各年龄组沉陷率间比较差异有显著性(P=0.032)。钛网端面有悬空和无悬空的沉陷发生率间差异有显著性(P=0.016)。单、双节段切除病例的沉陷率比较差异有显著性(P=0.020)。结论钛网沉陷以钛网后下部陷入下位椎体最多见,术后钛网沉陷发生率较高;高龄患者、钛网端面部分悬空及双节段是术后发生钛网沉陷的重要影响因素。

Objective To investigate imaging and related factors of subsidence of titanium mesh cage （TMC） after anterior cervical corpectomy with TMC and bone graft fusion. Methods 58 cases were collected with anterior cervical corpectomy TMC and bone graft fusion.According to the X-ray film at 1week and 3 months after operation the imaging of subsidence of TMC and its related factors were analyzed. Results TMC subsidence occurred in 31（53.4%）cases.Their imaging findings had TMC subsidence into the upper or lower adjacent vertebral,the rear of TMC into the lower adjacent vertebral was the most common;angle of anterior cervical plates and screw became smaller.The rates of TMC subsidence for men and women had no significant differences （P=0.875）.The rates of TMC subsidence for all age groups had significant differences （P=0.032）.The rates of TMC subsidence with suspending and without suspending were significantly different（P=0.016）.The rates of TMC subsidence for single and double segment were significantly different （P=0.020）. Conclusion The rear of TMC into the lower adjacent vertebral was the most common about TMC subsidence.The rate of TMC subsidence is higher.Elderly patients,titanium mesh surface suspending and double segment are important factors for TMC subsidence.