不同融合方法在颈椎病前路手术中的应用

目的 :分析 3种颈椎前路融合术的优缺点。方法 :用 3种融合方式对 133例因颈椎病患者行前路减压。其中单纯髂骨植骨单节段 2 1例 ,双节段 19例 ;Threadedfusioncage (TFC)加自体植骨单节段 18例 ,双节段 13例 ;自体髂骨植骨加钢板固定单节段 33例 ,双节段 2 9例。对患者的骨融合时间、并发症等进行分析。结果 :平均随访时间 2 0 .1月 ,3组单节段融合时间分别为 3.4 ,2 .8和 2 .5月 ,优良率分别为 85 .7% ,77.8%和 90 .9% ,并发症发生率为 2 3.8% ,2 7.98%和 0 .0 % ;双节段 3组融合时间分别为 3.7,3.2和 2 .7月 ,优良率分别为 78.9% ,6 9.2 %和 86 .2 % ,并发症发生率分别为 2 6 .3% ,30 .8%和 5 .9%。结论 :单纯髂骨植骨方法简单 ,但植骨块滑脱等并发症较多。TFC加自体植骨方法融合器沉降 ,椎间隙狭窄发生率高 ,多节段更甚 ,应慎重。髂骨植骨加钢板固定牢固 ,符合颈椎生物力学特性 ,并发症少

Different fusion techniques in the treatment of cervical spondylosis through anterior approach

Objective To analyze the advantages and disadvantages of 3 fusion techniques through cervical anterior approach.Methods Three fusion techniques were performed on 133 patients with cervical spondylosis to decompress through the anterior approach.Of them, 21 patients with 1 pathological segment involved and another 19 patients with 2 were treated only with auto iliac bone graft;18 patients with 1 pathological segment involved and another 13 with 2 were treated with TFC filled with cancellous bone of resected vertebra body;and 33 patients with 1 segment, 13 cases with 2 involved were treated with auto iliac bone graft and cervical spine plate fixation.Results All patients were followed up for an average of 20.1 months. For the one segment patients, the average fusion time of 3 techniques was 3.4, 2.8,and 2.5 months, respectively,the excellence rates were 85.7%, 77.8%, and 90.9%, respectively; the incidence rates of complications were 23.8%, 27.98%, and 0.0%,respectively. For the two segment patients, the average fusion time of 3 techniques was 3.7,3.2,and 2.7 months,respectively.The excellence rates were 78.9%, 69.2%, and 86.2%; and the incidence rates of complications were 26.3%,30.8%,and 5.9%,respectively.Conclusion The auto iliac bone graft is simple but has more complications such as sliding out of the graft. TFC filled with cancellous bone of resected vertebra body tends to break the end plate of cervical spine vertebrae. Auto iliac bone graft and cervical spine plate fixation have a good biomechanic character and its application has shown good prospects.