颈椎前路椎间盘切除并自体骨移植钛板固定术对多节段颈椎间盘退行性疾病的疗效分析

Anterior Cervical Discectomy and Fusion with Autograft and Titanium Plate for the Treatment of Multi-Level Cervical Disc Degenerative Disease

目的评价颈椎前路椎间盘切除自体髂骨移植钛板固定治疗多节段颈椎间盘退变病的临床和影像学效果。方法 28例患者接受了颈椎前路椎间盘切除自体骨移植钛板固定手术。临床结果评估采用日本矫形外科协会（JOA）评分和Odom标准,并对融合率、颈椎曲度和手术并发症进行了评估。结果 28例均获随访,平均24个月（9~36个月）JOA评分,术前（7.54±0.78）,术后3d（10.82±0.93）,术后6个月（14.14±0.74）,终访时（13.86±1.22）,术后各时点与术前相比差异均有统计学意义（均P〈0.05）。颈椎影像资料显示牢固融合25例（89.3%）,平均融合时间5.9个月。颈椎曲率为术前（14.96±1.90）°,术后3d（26.89±3.78）°,术后6个月（25.86±3.67）°,终访时（24.89±3.69）°,术后各时点与术前相比差异均有统计学意义（均P〈0.05）。结论在多节段颈椎退变病中应用颈椎间盘切除自体骨融合钛板固定术取得了有效减压和稳定脊柱等良好的临床和影像学效果。

Objective To evaluate the clinical and radiological outcomes of anterior cervical discectomy and fusion with autograft and titanium plate（ACDFP）for the treatment of multi-level cervical disc degenerative disease（CDDD）.MethodsTwenty-eight consecutive patients with multi-level CDDD underwent ACDFP.Clinical outcomes were evaluated by using Japanese Orthopaedic Association（JOA）scores and Odom＇s criteria.The fusion rate and spinal curvature at the operated levels and surgical complications were assessed.Results All the 28 patients were followed up for an average of 24months（range：9-36months）.The JOA score was（7.54±0.78）,（10.82±0.93）,（14.14±0.74）and（13.86±1.22）,respectively,before surgery,3days and 6months after surgery,and at thenal follow-up.Radiographs of the cervical spine revealed that the solid fusion was obtained in 25cases（89.3%）at a mean time of 5.9months.The cervical spinal curvature was（14.96±1.90）°before operation,（26.89±3.78）°at 3days after operation,（25.86±3.67）°at 6months after operation,and（24.89±3.69）°at the final follow-up.There were significant differences in the JOA score and cervical spinal curvature between before and at various time points after operation.Conclusion Treatment of multi-level CDDD by ACDFP can effectively decompress and stabilize the spine,yielding satisfactory clinical and radiological outcomes.