颈前路单cage植骨融合联合钢板内固定治疗无骨折脱位颈脊髓损伤

Treatment of cervical spinal cord injury without radiographic spinal fracture dislocation by anterior single cage implantation for interbody fusion combined with plates system

目的探讨颈前路单cage植骨融合联合钢板内固定治疗无骨折脱位颈脊髓损伤的临床疗效。方法采用颈前路单cage植骨融合联合钢板内固定治疗63例无骨折脱位颈脊髓损伤患者。比较术前、术后3周和末次随访的ASIA评分。结果患者均获得随访,时间4-60个月。ASIA评分：术前为（48.15±17.23）分,术后3周为（61.42±17.34）分,末次随访为（64.11±16.93）分;术后3周、末次随访与术前比较差异均有统计学意义（P〈0.05）,末次随访与术后3周比较差异无统计学意义（P〉0.05）。患者融合节段3-12个月均获得良好骨性融合,影像学复查显示减压充分、内固定位置良好。患者均无神经、血管损伤,均无cage移位、沉陷及钢板松动、移位、断裂等并发症。结论颈前路单cage植骨融合联合钢板内固定是治疗无骨折脱位颈脊髓损伤较为理想的方法。

Objective To evaluate the clinical effect of the treatment of cervical spinal cord injury without radio-graphic spinal fracture dislocation by anterior single cage implantation for interbody fusion combined with plates system. Methods Sixty-three cases with cervical spinal cord injury without radiographic spinal fracture dislocation were treated with applying anterior single cage implantation for interbody fusion combined with plates system. The ASIA scores were compared respectively before operation, 3 weeks and final follow-up after operation. Results Sixty-three cases were followed up for 4 - 60 months. The mean scores of ASIA was （48. 15 ± 17. 23 ） points at preoperative, （61. 42 ± 17. 34） points at 3 weeks postoperation, （ 64. 11 ±16.93） points at final follow-up. The ASIA scores showed statistical significance between preoperation and postoperation（ P 〈0. 05） ;and the difference was not signifi-cant between 3 week postoperation and final follow-up（P 〉0. 05） . All of the embedded osseous were fused, the fusing time was 3 ？12 months. All patients were not suffered from vascular injury or nerve injury,and there was no compli-cations of migration or subsidence of the whole cage, neither fixation loosening, migration, breakage. Conclusions Using anterior single cage implantation for interbody fusion combined with plates system is an ideal method of the treatment of cervical spinal cord injury without radiographic spinal fracture dislocation.