摘要
目的评估关节突关节内植骨在下颈椎后路减压融合术中的应用效果。方法选取多节段颈椎后纵韧带骨化症患者60例,均行颈椎后路单开门椎管扩大成形、侧块螺钉内固定术,利用随机数字表法将其分为观察组和对照组,每组30例。观察组患者行术中门轴侧植骨、开门侧关节突关节内植骨;对照组患者行术中门轴侧植骨、开门侧侧块表面植骨。比较2组患者手术前后日本骨科协会评估治疗(JOA)评分、疼痛视觉模拟量表(VAS)评分及骨性融合情况。结果患者骨性融合率为100%,且术后未见内固定失效发生。2组患者术后6、12个月JOA评分及疼痛VAS评分均较术前明显改善,差异有统计学意义(P<0.05)。结论关节突关节内植骨可以达到理想的治疗效果,可成为一种新的下颈椎后路减压融合术的植骨方法,可为关节突关节间融合器的设计提供临床依据。
Objective To evaluate the application effect of zygapophysial joint bone grafting in posterior decompression and fusion of lower cervical spine.Methods A total of 60 patients with multiple segment ossification of cervical posterior longitudinal ligament were selected and treated with posterior cervical single open-door laminoplasty and lateral mass screw internal fixation.These patients were divided into the observation group and the control group according to random number table method,with 30 cases in each group.Patients in the observation group were treated with intraoperative bone grafting on the portal shaft side and zygapophysial joint bone grafting on the portal side,and patients in the control group were treated with intraoperative bone grafting on the portal shaft side and bone grafting on the surface of the lateral mass on the portal side.The Japanese Orthopaedic Association(JOA)score,pain visual analogue scale(VAS)score and bone fusion of the two groups were compared before and after operation.Results The bone fusion rate of the patients was 100%,and no internal fixation failure occurred after operation.The JOA score and pain VAS score of patients in the two groups were significantly improved 6 months and 1 year after operation compared with those before operation,and the differences were statistically significant(P<0.05).Conclusion The zygapophysial joint bone grafting can achieve ideal therapeutic effect and become a new bone grafting method for posterior decompression and fusion of lower cervical spine,which can provide a clinical basis for the design of zygapophysial joint fusion cage.
作者
马飞
谢梦琦
郭明明
孟令志
张怡光
王琪
MA Fei;XIE Meng-qi;GUO Ming-ming;MENG Ling-zhi;ZHANG Yi-guang;WANG Qi(Department of Orthopedics,General Hospital of Northern Theater Command/Army Severe War Injury Treatment Center,Shenyang Liaoning 110016,China;Graduate School of Dalian Medical University,Dalian Liaoning 116044,China;Department of Orthopedics,Tianjin Hospital,Tianjin 300211,China)
出处
《局解手术学杂志》
2021年第8期680-685,共6页
Journal of Regional Anatomy and Operative Surgery
基金
辽宁省自然科学基金(2019-ZD-1034)。
关键词
关节突关节内植骨
颈椎后纵韧带骨化
下颈椎减压融合
颈椎侧块螺钉
侧块表面植骨
zygapophysial joint bone grafting
ossification of cervical posterior longitudinal ligament
decompression and fusion of lower cervical spine
cervical lateral mass screw
bone grafting on the surface of the lateral mass
