前路减压联合钛网及自锁定椎间融合器重建治疗多节段脊髓型颈椎病

发布时间：2018-04-15 16:33

本文选题：多节段脊髓型颈椎病 + 前路减压　；参考：《中国脊柱脊髓杂志》2017年08期

【摘要】：目的 :评价前路减压、钛网及自锁定融合器联合重建治疗多节段脊髓型颈椎病的临床疗效及安全性。方法:回顾性分析2012年1月~2014年8月我院行前路减压、钛网与自锁定融合器联合重建治疗的多节段脊髓型颈椎病患者,共32例。其中男17例,女15例。年龄53~74岁,平均65.7±4.2岁。患者影像学上均表现为连续3个节段及以上的脊髓受压,且保守治疗无效。所有患者均为脊髓型颈椎病患者,其中11例患者合并神经根型颈椎病。采用JOA评分及Odom标准评价神经功能及临床效果。观察并记录手术的并发症、融合率、融合器下沉及手术后颈椎生理曲度的变化。结果:手术均顺利完成,钛网及融合器置入成功。平均手术时间113.0±12.5min;术中平均失血量123.0±9.4ml。平均随访时间23.2±2.3个月(12~41个月)。末次随访时JOA评分及颈椎生理曲度均较术前明显增加,并有统计学意义(P0.05)。32例患者均获得融合,平均融合时间6.4±0.7个月。无内固定失败,无浅表及深部感染。术后并发症包括脑脊液漏1例(3.1%),经保守治疗7d后治愈。钛网沉降2例(6.2%),患者无临床症状;自锁定融合器无沉降。无吞咽困难及声音嘶哑。根据Odom标准,术后疗效优11例,良好17例,一般4例。结论:前路减压、钛网及自锁定融合器联合重建治疗多节段脊髓型颈椎病,安全有效,能够有效恢复颈椎曲度,减少长钛板相关并发症,并获得满意临床结果。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of anterior decompression, titanium mesh and self-locking fusion cage in the treatment of multilevel cervical Spondylotic myelopathy.Methods: from January 2012 to August 2014, 32 patients with multilevel cervical Spondylotic myelopathy underwent anterior decompression and reconstruction with titanium mesh and self-locking fusion cage.There were 17 males and 15 females.The average age was 65.7 卤4.2 years.All the patients showed three consecutive segments of spinal cord compression, and the conservative treatment was ineffective.All the patients were cervical Spondylotic myelopathy, 11 of them were complicated with cervical spondylopathy of nerve root type.Nerve function and clinical effect were evaluated by JOA score and Odom standard.The complications, fusion rate, sinking of fusion cage and changes of physiological curvature of cervical spine after operation were observed and recorded.Results: the operation was completed successfully and the titanium mesh and fusion cage were implanted successfully.The mean operative time was 113.0 卤12.5 min and the average blood loss during operation was 123.0 卤9.4 ml.The mean follow-up time was 23.2 卤2.3 months.At the last follow-up, the JOA score and the physiological curvature of cervical vertebrae were significantly increased compared with those before operation, and the mean fusion time was 6.4 卤0.7 months.No failure of internal fixation, no superficial and deep infection.The postoperative complications included cerebrospinal fluid leakage (CSF) in 1 case (3.1%), which was cured after 7 days of conservative treatment.Titanium mesh sedimentation was found in 2 patients with no clinical symptoms and self-locking fusion cage without sedimentation.No dysphagia and hoarseness.According to Odom standard, 11 cases were excellent, 17 cases were good and 4 cases were fair.Conclusion: anterior decompression, titanium mesh and self-locking fusion cage combined with reconstruction in the treatment of multilevel cervical Spondylotic myelopathy are safe and effective, can effectively restore cervical curvature, reduce complications associated with long titanium plate, and obtain satisfactory clinical results.
【作者单位】：复旦大学附属中山医院骨科;
【基金】：国家自然科学基金(81301577) 上海市青年科技启明星计划(15QA1401000) 高等学校博士学科点专项科研基金(20130071120062)
【分类号】：R687.3

【相似文献】