零切迹椎间融合器植入治疗多节段脊髓型颈椎病

发布时间：2018-06-28 21:31

本文选题：颈椎 + 内固定器　；参考：《中国组织工程研究》2017年27期

【摘要】：背景:颈椎前路减压植骨融合内固定治疗多节段脊髓型颈椎病在临床上已得到广泛应用,然而术后并发症较多。目的:比较零切迹融合器与颈椎前路减压植骨融合应用于多节段脊髓型颈椎病治疗效果。方法:71例多节段脊髓型颈椎病患者随机分成2组,分别为前路减压零切迹融合器植入组、及前路减压钛板联合cage固定组,采用脊髓功能JOA评分,融合率,吞咽困难、食管漏发生率等指标对比2组疗效。结果与结论:①内固定后随访3-34个月,平均17.5个月。末次随访两组患者脊髓功能恢复优良率差异无显著性意义;②2组最终融合率无差别,但6个月及9个月时零切迹融合器植入组融合率高于钛板联合CAGE固定组(P0.05);③零切迹融合器植入组术后吞咽困难发生率3%(轻度1例),钛板联合CAGE固定组29%(轻度3例,中度5例,重度2例),差异有显著性意义(P0.05);零切迹融合器植入组无内固定松动、移位发生,而钛板联合CAGE固定组可见1例螺钉松动,2例融合器向后移位的情况发生;零切迹融合器植入组出血量、手术时间及术中透视次数均低于钛板联合CAGE固定组(P0.05);④结果提示,颈椎前路减压零切迹融合器植入与传统减压植骨融合治疗多节段脊髓型颈椎病相比,在促进脊髓功能恢复方面及最终融合率无显著差异,但术后内固定稳定性好,中期融合率高,术后吞咽困难发生率低。
[Abstract]:Background: anterior cervical decompression and fusion and internal fixation have been widely used in the treatment of multilevel cervical Spondylotic myelopathy. Objective: to compare the effect of zero notch fusion cage and anterior cervical decompression and bone grafting in the treatment of multilevel cervical Spondylotic myelopathy. Methods Seventy-one patients with multisegmental cervical Spondylotic myelopathy were randomly divided into two groups: anterior decompression zero notch fusion cage implantation group and anterior decompression titanium plate combined with cage fixation group. Spinal cord function score, fusion rate and dysphagia were used. The incidence of esophageal leakage and other indicators were compared between the two groups. Results and conclusion the follow-up period was 3-34 months, with an average of 17.5 months. There was no significant difference in the excellent and good rate of recovery of spinal cord function between the two groups after the last follow-up. There was no significant difference in the final fusion rate of the 22 groups. But at 6 and 9 months, the fusion rate of zero notch fusion cage group was higher than that of titanium plate combined with cage group (P0.05), the incidence of dysphagia was 3% (mild 1 case), and 29% (mild 3 cases, moderate 5 cases) in titanium plate combined with cage group. There was no internal fixation loosening and displacement in the zero notch fusion cage group, while in the titanium plate combined with cage group, 1 case of screw loosening and 2 cases of backward displacement of the fusion cage were observed. The amount of blood loss, the operation time and the times of fluoroscopy in the group of zero notch fusion cage implantation were lower than those in the group of titanium plate and cage fixation (P0.05). Compared with the traditional decompression and bone graft fusion, there was no significant difference in the recovery of spinal cord function and the final fusion rate between the anterior decompression and zero notch fusion cage and the traditional decompression and bone graft fusion, but the stability of internal fixation after operation was good. The rate of mid-term fusion was high and the incidence of dysphagia was low.
【作者单位】：新乡医学院第一附属医院骨科;
【基金】：河南省医学科技攻关计划项目(201403141)~~
【分类号】：R687.3

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