颈椎前路椎体次全切除后钛网下沉原因及对颈神经功能的影响

发布时间：2018-03-09 06:16

本文选题：颈椎　切入点：脊髓压迫症　出处：《中国组织工程研究》2017年15期 　论文类型：期刊论文

【摘要】：背景:颈椎前路椎体次全切除伴钛网植入术是颈椎脊髓压迫性病变常规有效的治疗方式之一,其术后并发症尤其是钛网下沉较为多见。钛网下沉的危险因素及对手术效果的影响目前仍存在争议。目的:观察颈椎前路椎体次全切除伴钛网植入术后钛网下沉的发生情况及对修复效果的影响,分析其原因探索可能的危险因素。方法:回顾性分析2015年3至9月于解放军第二军医大学附属长征医院脊柱二科行颈椎前路椎体次全切除伴钛网植入术34例患者的临床资料,随访12个月,测量患者手术节段椎间高度,计算颈椎JOA评分。随访时椎间高度较术后1 d下降超过3 mm即定义为钛网下沉,将患者分为下沉组及非下沉组。结果与结论:(1)共有19例患者出现术后钛网下沉,发病率为56%,平均发生于术后(6.00±3.73)个月;(2)下沉组与非下沉组患者年龄、性别构成、手术节段数之间差异均无显著性意义(P=0.731,0.672,0.053);(3)通过颈椎JOA评分计算改善率,非下沉组患者术后改善率显著高于下沉组(P=0.01),提示钛网下沉与术后神经功能改善不佳可能有一定联系;(4)综上所述,颈椎前路椎体次全切除术后钛网下沉较为常见,而且会影响颈椎修复效果。患者年龄、性别、手术节段均不是钛网下沉的独立危险因素。
[Abstract]:Background: anterior subtotal cervical vertebra resection with titanium mesh implantation is one of the conventional and effective methods for the treatment of cervical spinal cord compression lesions. The risk factors of titanium mesh sinking and its influence on the effect of operation are still controversial. Objective: to observe the titanium mesh subsidence after anterior subtotal cervical vertebra resection with titanium mesh implantation. And its effect on the restoration effect, Methods: the clinical data of 34 cases of anterior cervical vertebra subtotal excision with titanium mesh implantation were analyzed retrospectively from 2015 to September in the Department of Spine of long March Hospital affiliated to the second military Medical University of the people's Liberation Army. After 12 months of follow-up, the intervertebral height was measured and the cervical JOA score was calculated. The reduction of intervertebral height by more than 3 mm compared with that at 1 day after operation was defined as titanium mesh sinking. Results and conclusion there were 19 patients with postoperative titanium mesh sinking, the incidence of which was 56. The average incidence was 6.00 卤3.73 months after operation) the age and sex of the patients in the sinking group and non-sinking group were 6. 00 卤3. 73 months. There was no significant difference in the number of surgical segments. The improvement rate was calculated by JOA score of cervical vertebrae. The rate of postoperative improvement in non-sinking group was significantly higher than that in subtotal cervical vertebrae group, suggesting that there might be a certain connection between the subsidence of titanium mesh and the improvement of postoperative nerve function. In conclusion, titanium mesh sinking was more common after subtotal cervical vertebra resection. Age, sex, and surgical segment are not independent risk factors for titanium mesh sinking.
【作者单位】：解放军第二军医大学附属长征医院;
【基金】：上海市科学技术委员会科研计划项目(12411950700);项目名称:应用复合明胶纳米纤维膜构建人工硬脊膜修复硬脊膜缺损的实验研究;项目负责人:陈德玉~~
【分类号】：R687.3

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