带锁钛钢板在颈前路应用中的有关问题

Discussion on the anterior locking cervical plate systems

目的 :观察颈前路带锁钛钢板内固定的疗效及其并发症 ,分析并发症的产生原因并提出预防及治疗措施。方法 :随访使用CSLP、ORION及CODMAN三种颈前路带锁钢板治疗颈椎骨折脱位、颈椎病、结核和肿瘤共 15 0例。结果 :随访 3～ 6个月 ,除死亡 3例外 ,其余病人神经系统症状均有不同程度的恢复 ,结核和肿瘤病灶无复发 ,植骨块也在术后 3个月获骨性愈合 ,但 15 0例病例中出现了 6种共 19例次与使用钢板有关的并发症。包括固定螺钉进入椎间隙 ,钢板偏斜 ,单一螺钉部份退出 ,钢板螺钉部分拔出 ,颈椎生理曲度变直或消失。结论 :颈前路带锁钛钢板内固定能使固定的节段达到内在的稳定 ,有利于植骨块的愈合 ;但应根据情况正确的选择钢板 ,并熟悉颈椎的解剖特点、术中暴露清楚、熟练操作技术是预防其并发症发生的关键。

Objective:To observe the result and to study the complications and prevention methods for the different anterior locking cervical plate systems.Methods:150 patients with the cervical fracture-dislocations,spondylotic myelopathy,tuberclusis and tumors of the cervical spine were treated using CSLP?ORION and CODMAN anterior locking cervical plate systems.Results:All the patients were followed up for 3-6 months. The symptom of nervous system recovered,and the bone grafting was fused completely.The complications related to the anterior cervical plate occurred including protrusion of the fixation screws into disc pace,defluxion of the plate,migration of the screws and plate.Most of the complications were caused by insufficient exposure and improperly technological performance.Conclusion:Anterior locking cervical plate systems can provide reliable stability for the fixation segments and it is useful for fusion of the grafting bone,it is important to be familiar with anatomical knowledge of the cervical vertebrae,sufficient exposure of the lesion,correct plate selection and proper technical principles of the different anterior locking cervical plate systems play an important role in avoiding the complications.