摘要
目的观察颈椎前路动态ABC钢板促进颈椎椎体间植骨融合的疗效。方法对40例患者(68个节段)行颈椎前路椎间盘摘除、椎体间自体髂骨植骨、ABC钢板内固定术。术后观察ADL评分,颈椎曲度、椎体间融合及融合植骨块下沉情况。结果40例均获随访,时间12～44(22.17±8.33)个月。ADL评分术前2～13(7.92±3.07)分,术后8～17(13.94±2.48)分,改善明显。术后无钢板、螺钉断裂或松动现象发生。39例颈椎生理性前凸获得良好改善,仅1例术后3个月融合椎体邻近节段发生反曲,患者颈部无不适症状。68个融合节段中,67个节段6个月内融合,1个节段延迟至术后12个月时方融合。术后3个月内,单节段融合植骨块下沉平均(1.21±0.54)mm,2节段平均(2.01±0.87)mm,3节段平均(2.97±0.82)mm。3个月后各节段下沉不再明显。结论应用动态ABC钢板可以降低植骨后相关并发症的发生,有效避免静态钢板造成的应力遮挡,从而促进颈椎椎体间的融合。
Objective To evaluate the clinical outcomes in the patients undergoing anterior cervical dynamic ABC plating, during the cervical disceetomy and intervertebral fusion. Methods A total of 40 patients were performed cervical discectomy, intervertebral fusion with autogenous iliac crest graft and instrumentation using dynamic ABC plating. Preoperative and postoperative ADL score were evaluated. Cervical lordosis, subsidence and fusion were assessed by radiographs at postoperative 7 days, 3, 6, and 12 months. Fusion evidence was observed by CT scan at postoperative 3, 6, and 12 months. Results The mean follow-up period was 22. 17 ± 8.33 months （range, 12 ～44 months）. The mean ADL score was improved from 7.92 ± 3.07 preoperatively to 13.94 ± 2. 48 postoperatively. There was no implants breakage or loosening. Lordosis was improved in 39 of 40 patients. Successful fusion was observed in all of cases. The average subsidences for single-level, two-level, and three-level fusions were （ 1.21 ± 0. 54） mm, （2. 01 ±0. 87） mm, and （2. 97 ±0. 82） mm, respectively. Conclusions Effective arthrodesis and a low incidence of complications following cervical discectomy and intervertebral fusion are attributed to reduced stress shielding and greater graft compression afforded by dynamic ABC plating. Applying dynamic ABC plates is biomechanically advantageous in cervical spine fusion.
出处
《临床骨科杂志》
2008年第5期391-393,共3页
Journal of Clinical Orthopaedics
关键词
颈椎
椎间盘切除
脊柱融合术
动力
钢板
cervical vertebrae
discectomy
spinal fusion
dynamic
plating
