颈椎前路减压、纳米羟基磷灰石/聚酰胺人工椎体椎间融合内固定治疗脊髓型颈椎病效果观察

目的探讨颈椎前路减压、纳米羟基磷灰石/聚酰胺(n-HA/PA66)人工椎体椎间融合内固定治疗脊髓型颈椎病的临床疗效。方法对26例脊髓型颈椎病患者采用颈椎前路减压、n-HA/PA66人工椎体椎间融合内固定术治疗,治疗后观察其疗效。结果全部患者获得随访6～24个月(平均14个月),大部分患者症状明显缓解,部分患者症状基本消失,颈椎活动无明显受限。术后平均改善率为73.4%,其中优14例占53.8%,良7例占26.9%,中4例占15.4%,差1例占3.8%。影像学显示所有患者椎间高度恢复良好,椎体间均发生融合。结论颈椎前路减压、n-HA/PA66人工椎体椎间融合内固定治疗脊髓型颈椎病能直接解除脊髓受压、重建颈椎稳定性,获得较高的融合率,是治疗脊髓型颈椎病的有效方法。

Effect observation of anterior cervical decompression, intervertebral fusion with nano-hydroxyapatite/polyamide for artificial vertebrae and plate fixation in cervical spondylotie myelopathy

Objective To evaluate clinical efficiency of cervical spondylotic myelopathy treated by anterior cervical decompression, intervertebral fusion with artificial vertebral body of the biomimetic nano-hydroxyapatite/polyamide （n-HA/ PA66 ） composites, fixation with titanium plate. Methods 26 cases patients of cervical spondylosis myelopathy were treated by anterior semivertebra decompression, intervertebral fusion with artificial vertebral body of the biomimetic n-HA/PA66 composites,fixation with titanium plate,observed the clinical effect after the treatment. Results All the 26 cases were followed up 6 -24months（ the average follow-up 14 months）, symptoms improved obviously in most patients and disappeared in partial patients, and the movement of cervical vertebrae had not obvious limit. The average ratio of improvement in neurological function was 73.4% ,including excellent in 14 cases（53.8% ） ,good in 7 cases（26.9% ） ,fair in 4 cases（ 15.4% ） and bad in 1 case （3.8%）. The postoperative X-ray film demonstrated that the height of intervertebral space had restored and all cases were gained solid fusion. Conclusion The surgical treatment of cervical spondylotic myelopathy with anterior cervical decompression,intervertebral fusion with artificial vertebral body of the biomimetic n-HA/PA66 composites and fixation with titanium plate can finish decompression to cervical cord safely and reconstruct stability of cervical vertebrae obtain high ratio of fusion. It＇s a rational and effective method for the surgical treatment of cervical spondylotic myelopathy.