摘要
目的:观察颈椎前路减压植骨可吸收螺钉内固定治疗颈椎病的初步临床疗效。方法:2007年3月～2008年9月我院应用颈椎前路减压植骨可吸收螺钉内固定治疗颈椎病患者26例,男16例,女10例,年龄38～70岁,平均49.4岁。脊髓型颈椎病11例,神经根型颈椎病5例,混合型颈椎病10例。1个椎间隙受压8例,2个椎间隙受压18例。所有患者采用标准颈椎前路减压、自体髂骨块植骨,应用可吸收全螺纹螺钉自植骨块纵轴中线与冠状面呈45°角方向将植骨块固定于上、下椎体。术后常规颈托固定4～6周。每月门诊随访拍片,观察植骨块位置及植骨愈合情况,了解植骨块融合时间;应用JOA评分评估神经恢复情况。结果:手术均顺利完成,可吸收螺钉固定顺利。术后1周,患者手术切口均I/甲愈合。全部病例获4～18个月平均12.6个月随访,植骨块与周围融合时间3.2～4.6个月,平均3.3±0.6个月,症状改善总体优良率84.2%,未观察到明显全身不良反应及局部并发症。结论:颈椎前路减压植骨可吸收螺钉内固定术可有效治疗单或双节段颈椎病,避免金属内固定物产生的相关并发症。
Objective：To observe the early clinical effect of the cervical spondylosis treated by the fixation with bio-absorbable screw after cervical anterior decompression and bone graffing.Method：26 cases suffered from cervical spondylosis who were treated by anterior compression,bone grafting and fixating with 2 bio-absorbable screws from Mar. 2007 to Sep. 2008,including 16 males and 10 females with an average age of 49.4 years （38-70 years ） .There were 11 cases with cervical spondylotie myelopathy,5 with cervical spondylotic radiculopathy and 10 with mixed type of cervical spondylosis.Clinical data of these patients was analyzed ret- rospectively.One intervertebral space involvement was in 8 cases,and two spaces involvement in 18 cases.All patients underwent anterior decompression and bone grafting,in which the grafted bone was fixated by 2 bioabsorptive screws （PLLA,diameter：2.7mm） from the midline of graft bone to the bone surface of upper and lower vertebrae in 45°.Cervical collar was commonly used for 4-6 weeks after operation.All cases were followed-up every month in outpatient department to observe the improvement of symptoms and evaluate the fu- sion of bone graft.Neurological function recovery was observed by JOA score.Result：Operations of all cases were finished and screws were placed successfully.The operative incisions healed well.The excellent and good rate of symptom improvement was 84.2%,the graft fusion time was 3.3±0.6 months （range,3.2-4.6 months）. No obvious complications were found.Conclusion：The cervical spondylosis with one or two-level involvement can be effectively treated by anterior decompression and bone grafting with bio-absorbable screw fixation.This operative method is safe and can avoid the complications induced by metal implants.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2009年第7期526-529,共4页
Chinese Journal of Spine and Spinal Cord
关键词
颈椎病
可吸收螺钉
植骨
内固定
Cervical spondylosis
Bioabsorbable screw
Bone grafting
Fixation
