原位旋转植骨在颈椎前路减压融合术中的应用

The Effect of Application with in situ Rotated Circular Graft for Arthrodesis after Anterior Cervical Decompression

目的 :观察原位旋转植骨在颈椎前路减压融合术中植骨融合的效果及临床疗效。方法 :应用Cloward法行颈椎前路减压 +原位旋转植骨融合术治疗 2 16例颈椎病变患者 ,随访 1～ 6年 ,影像观察植骨融合情况及颈椎曲度的变化。按 40分评分评定临床疗效。结果 :疗效 优 112例 ( 5 1.9% ) ,良 76例 ( 35 .2 % ) ,有效 2 1例 ( 9.7% ) ,无效 6例( 2 .8% ) ,加重 1例 ( 0 .4% ) ,优良率 87.1%。影像表现 :术后 2～ 3个月植骨块愈合。术后 1年单节段植骨颈椎保持较好前凸 ,2 4例 2～ 3节段植骨出现前凸消失 ,2 1例颈椎反曲。结论 :原位旋转植骨简便、骨融合较快 ,临床疗效好 ,在 2节段以内的颈椎前路减压融合术中具有明显的优势。

Objective: To observe the efficacy of fusion and clinical results after anterior cervical decompression and fusion with in situ rotated circular graft. Methods: 216 cases underwent Cloward's anterior cervical decompression and fusion with in situ rotated circular graft from May 1995 to May 2000 were investigated. All cases were followed up for at least 1 year. The clinical results were analyzed according to 40 score system. The fusion outcome were assessed by computer radiographs, CT or MR of the cervical spine. Results: Clinical results were excellent in 112 patients, good in 76, fair in 21, poor in 6 and worse in 1 case. CR,CT and MRI showed subsidence in 1case and solid fusion could be got in 2～3 months after operation. The cervical curves represented well in patients with 1～2 fusion segments. However, there appeared straight or adverse curve in 24 patients with 2～3 fusion segments. Conclusions: In situ otated circular graft can be used for arthrodesis in anterior cervical decompression, especially in patients with in 1～2 involved segments.