颈前路减压椎间融合器植骨融合术治疗单节段脊髓型颈椎病临床观察

发布时间：2018-04-06 00:41

本文选题：脊髓型颈椎病　切入点：单一颈椎节段　出处：《山东医药》2017年16期

【摘要】：目的对比分析颈前路减压椎间融合器(cage)植骨融合术与自体髂骨植骨融合钛板内固定术治疗单节段脊髓型颈椎病的临床疗效及安全性。方法选择单节段脊髓型颈椎病患者73例,随机分为cage融合组35例和植骨融合组38例。分别行颈前路减压cage植骨融合术及颈前路减压自体髂骨块植骨融合钛板内固定术治疗。记录两组手术时间、术中出血量、治疗期间并发症发生情况及植骨融合情况,比较两组术前、术后1周及术后18个月日本颈椎矫形外科学会评分(颈椎JOA评分)、椎间高度、颈椎曲度。结果 cage融合组手术时间、术中出血量及一过性咽部不适、供骨区疼痛发生率均低于植骨融合组(P均0.05)。两组植骨融合率比较差异无统计学意义(P0.05)。与同组术前比较,两组术后1周及18个月颈椎JOA评分、椎间高度、颈椎曲度均升高(P均0.05),而两组术后1周及18个月上述指标比较差异均无统计学意义(P均0.05)。结论颈前路减压cage植骨融合术与自体髂骨植骨融合钛板内固定术治疗单节段脊髓型颈椎病的近期及远期效果均较好,但cage植骨融合术手术操作更简单、安全性更高。
[Abstract]:Objective to compare the clinical efficacy and safety of anterior cervical decompression cage cage bone graft fusion and autogenous iliac bone fusion titanium plate fixation in the treatment of single segment cervical Spondylotic myelopathy.Methods 73 patients with single segment cervical Spondylotic myelopathy were randomly divided into cage fusion group (n = 35) and bone graft fusion group (n = 38).Anterior cervical decompression with cage and anterior cervical decompression with autogenous iliac bone graft and titanium plate fixation were performed.The time of operation, the amount of intraoperative bleeding, the incidence of complications and bone graft fusion during treatment were recorded in the two groups. The Japanese Society of Orthopaedic surgery scale (JOA score of cervical spine, intervertebral height) was compared between the two groups before, 1 week and 18 months after operation.Cervical curvature.Results the operative time, blood loss and temporary pharynx discomfort in cage fusion group were lower than those in bone graft fusion group (P < 0.05).There was no significant difference in bone graft fusion rate between the two groups (P 0.05).Compared with the same group before operation, the JOA score, intervertebral height and cervical curvature increased in both groups at 1 week and 18 months after operation (P < 0.05), but there was no significant difference between the two groups at 1 week and 18 months after operation (P 0.05).Conclusion anterior cervical decompression and cage fusion with autogenous iliac bone graft and titanium plate internal fixation are effective in the treatment of single segment cervical Spondylotic myelopathy in the short and long term, but the operation of cage fusion is simpler and more safe.
【作者单位】：皖南医学院附属马鞍山市中心医院;皖南医学院第一附属医院弋矶山医院;
【分类号】：R687.3

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