颈椎前路钛板在颈椎前路减压融合术中的应用

Value of titanium plate fixation in anterior decompression and arthrodesis for cervical disorders

目的探讨前路钛板在手术治疗颈椎创伤、脊髓型颈椎病、颈椎肿瘤等病变中的作用。方法应用前路钛板治疗颈椎创伤与疾病22例,其中脊髓型颈椎病(包括颈椎间盘突出)13例,颈椎骨折5例,后纵韧带骨化症2例,颈椎肿瘤2例。结果本组22例均获随访,随访时间5个月～3年5个月,平均1.5年,21例植骨块与上下椎体融合(95.5%),1例不融合(4.5%)。无钛板松动断裂、移位,亦无植骨块脱出压迫食道。术后除1例脊柱骨折脱位脊髓损伤症状无恢复者,其它均有不同程度的恢复,优良率86.1%。结论颈椎前路钛板内固定具有显著的优越性,可起到术后即刻稳定、防止植骨块移位、术后无需行石膏外固定、明显提高植骨融合率等作用。但应严格掌握手术指征和操作技术,以减少或避免并发症发生。

Objective To investigate the application of titanium plate f ixation in the treatment of cervical spine trauma, cervical myelopathy and spina l tumor. Methods 22 patients with cervical myelopathy (n=13), cervical spine fra cture (n=5), ossification of posterior longitudinal ligament (n=2) and tumor (n= 2) were treated by anterior decompression, bone autograft fusion and titanium pl ate fixation. Results All the 22 cases were followed up for 5 months to 41 month s after surgery, with an average of 17 months. Bone graft fusion was found in 21 cases (95.5%), with the exception of only 1 case (4.5%). No complications occ urred in the present study, such as loosening, displacement or breakage of the p late, or bone graft migration encroaching the esophagus. The excellent and good rate was 86.1%. Conclusions The anterior cervical titanium plate has such advan tages as immediate stabilization of the cervical spine, prevention of bone graft migration, no need to use plaster after surgery and increased rate of fusion. H owever, since some complications associated with the plate and screw were report ed occasionally, we should pay close attention to the indications and accurate p rocedure of the operation and the probability of the complications.