前路颈椎间盘桥式自锁定PEEK椎间融合器的临床应用及中远期疗效研究

发布时间：2018-12-09 09:45

【摘要】：目的探讨前路颈椎间盘切除减压融合术(ACDF)中应用桥式自锁定PEEK(MC+PEEK)椎间融合器治疗颈椎病的中远期疗效。方法选取2011年6月—2015年8月在宜春市人民医院应用MC+PEEK椎间融合器行ACDF患者41例,共置入MC+PEEK椎间融合器67枚。对患者进行定期随访,采用疼痛视觉模拟评分(VAS)和日本骨科学会颈椎病疗效评定标准(JOA)评估患者术后神经功能恢复情况;Bazaz吞咽困难评价标准、Park邻近节段骨化分级标准及UCLA椎间隙退变分级标准分别评估术后吞咽困难、邻近节段骨化和椎间隙退变情况;术后定期行颈椎X线、CT、MRI检查观察植骨融合、椎间隙高度、颈椎曲度等情况。结果共37例患者获得随访,平均随访时间为(47.8±5.0)个月。术前VAS为(5.7±0.3)分,高于末次随访时的(1.4±0.8)分(P0.001)。术前JOA评分为(9.2±2.2)分,低于末次随访的(15.0±4.6)分(P0.001)。至末次随访时,2例患者出现轻度吞咽困难,发生率为5.4%;均未见邻近节段骨化和椎间隙退变表现。患者融合节段均植骨融合满意,融合时间为3~6个月,6个月时融合率为100.0%。术前椎间隙高度为(5.8±1.5)mm,低于末次随访时的(8.3±0.9)mm(P0.001)。术前颈椎曲度为(3.9±0.5)mm,低于末次随访时的(7.3±2.0)mm(P0.001)。结论 ACDF中应用MC+PEEK椎间融合器治疗颈椎病具有操作简单、出血少、并发症少,改善和维持颈椎曲度和椎间隙高度等优点,中远期临床疗效满意。
[Abstract]:Objective to investigate the mid-and long-term effect of anterior cervical discectomy and decompression fusion (ACDF) with bridge self-locking PEEK (MC PEEK) fusion cage in the treatment of cervical spondylosis. Methods from June 2011 to August 2015, 41 patients with ACDF were treated with MC PEEK interbody fusion cage in Yichun people's Hospital. 67 MC PEEK interbody fusion cages were inserted. The patients were followed-up regularly, and the patients were evaluated with (VAS) and (JOA), which were used to evaluate the recovery of nerve function after operation. Bazaz criteria for evaluation of dysphagia, Park proximal ossification grade and UCLA intervertebral space degeneration were used to evaluate postoperative dysphagia, ossification of adjacent segments and degeneration of intervertebral space. X-ray and CT,MRI were performed regularly after operation to observe the fusion of bone graft, height of intervertebral space and curvature of cervical spine. Results A total of 37 patients were followed up for an average of (47.8 卤5.0) months. Preoperative VAS score (5.7 卤0.3) was higher than that at the last follow-up (1.4 卤0. 8) (P0. 001). The preoperative JOA score was (9.2 卤2.2), lower than that of the last follow-up (15.0 卤4.6) (P0.001). At the last follow-up, 2 patients had mild dysphagia with an incidence of 5.4%, and no adjacent ossification or intervertebral space degeneration was found. The fusion time was 3 ~ 6 months and the fusion rate was 10. 0 at 6 months. The preoperative height of intervertebral space was (5.8 卤1.5) mm, lower than that at the last follow-up (8.3 卤0.9) mm (P0.001). The cervical curvature before operation was (3.9 卤0.5) mm, lower than that at the last follow-up (7.3 卤2.0) mm (P0.001). Conclusion the application of MC PEEK interbody fusion cage in the treatment of cervical spondylosis in ACDF has the advantages of simple operation, less bleeding, less complications, improvement and maintenance of cervical curvature and height of intervertebral space.
【作者单位】：江西省宜春市人民医院骨科;
【基金】：江西省科技计划资助项目(2014BBG70038)
【分类号】：R687.3

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