颈椎前路异体骨移植内固定重建颈椎稳定性

Anterior cervical discectomy and fu sion with allograft and internal fixation

目的:探讨异体骨移植结合钛钢板、一体化钛钢板融合器及钛网进行颈椎前路重建治疗颈椎病的效果。方法:1999年12月至2002年3月应用冻干异体骨移植结合前路钛钢板固定、一体化钛钢板融合器固定或钛网结合前路钛钢板固定重建颈椎稳定性治疗126例颈椎病患者,共随访67例,平均随访时间13.6±2.7个月,按JOA评分及Nurick分级评定手术效果,X线检查判定融合效果。结果:所有病人术后伤口均一期愈合。JOA评分从术前的12.37±1.60分提高到16.28±1.09分(P<0.05);Nurick分级从术前的2.47±0.58级提高到术后的0.77±0.81级(P<0.05)。术后病变椎间隙高度得到恢复,颈椎生理前凸部分或全部恢复,植骨块无移位、脱落、塌陷,无融合器或钛网脱出、移位及突入上下椎体中的情况,钛钢板及螺丝钉无移位及松脱。结论:颈椎前路异体骨移植内固定重建治疗颈椎病近期观察证实,颈椎稳定性获得重建,效果可靠。

O bjective:To evaluate the effect of allograft in the anterior cervical fusion for cervical spondylosis with anterior instrumentation.Method:The clinical outcome of126cervical spondylosis undergone discectomy and allograft enhanced by anterio r titanium plate system was retrospectively studied.In this group,freeze-dried f ibula ring alone or freeze-dried cancellous bone impacted into cages or meshes w ere used for allograft.67patients of126cases were followed up clinically and rad iographically.The mean follow-up time was13.6±2.7months.Result:In all patients of67cases,statistical analysis of all patients revealed the mean JOA scores of12 .37±1.60and16.28±1.09before surgery and at final examination(P<0.05),respectiv ely.And the means Nurick grades were2.47±0.58and0.77±0.81before and after surg ery(P<0.05),respectively.The X-ray films demonstrat-ed that the height of the i ntervertebral space and the lordosis of the cervical spine had been restored and no fibula rings or cages or meshes were found displaced,collapsed or subsidence d into adjacent vertebral bodies.Conclusion:The fibular allograft and cancelous allograft impaceted into cages and meshes gained excellent or good result clinic ally and radiographicall.