颈前路减压后自体髂骨与钛网植骨重建颈椎稳定性对比研究

目的：比较颈前路减压自体髂骨植骨与钛网植骨重建颈椎稳定性。方法：脊髓型颈椎病患者41例，男23例，女18例；年龄39～63岁；病程9个月～3．9年。随机分为两组，采用颈前路减压自体髂骨植骨22例；钛网植骨加Orion钢板内固定19例。观察椎间隙高度变化，生理曲度变化，植骨融合率及融合时间。结果：所有患者均获随访，随访时间10～40个月，平均23．2个月。植骨均获骨性愈合，植骨融合时间，椎间高度丢失，Cobb角丢失，两组比较均有统计学差异，自体髂骨植骨组优于钛网植骨组。术前后椎间高度比较两组均有显著变化（P〈0．01）。结论：两种融合方式近期均能有效重建和维持颈椎稳定性，但在融合时间，椎间高度丢失，生理曲度丢失方面髂骨植骨优于钛网植骨。钛网植骨并不具有独特优点，应严格掌握适应证。

Comparison of stability of reconstraction cervical vertebrae with iliac crest autograft and Ti-alloy mesh by decompression through anterior approach

Objective:To compare the stability of reconstraction cervical vertebrae with iliac crest autograft and Ti-alloy mesh by decompression through anterior approach.Methods:Forty-one patients with cervical spondylotic myelopathy(23 male,18 female,the age from 39 to 63 years,the course from 9 months to 3.9 years)were randomly divided into two groups.Among them,22 patients were treated with iliac crest autograft by through anterior approach;The other 19 patients were treated with Ti-alloy mesh graft and Orion plate fixation.The postoperative intervertebral height,the curve of cervical spine,the rate and time of grafting bone fusion were observed.Results:All patients were followed up from 10 to 40 months(mean,23.2 months).The grafting bone were fusioned completely in all patients.There were statistical difference on the fusional time,the changes of intervertebral height,the lost Cobb angle between the two groups(P<0.01).The change of intervertebral height of two groups were statistical difference between before and after operation(P<0.01).Conclusion:This two methods can effectively reconstruct and keep the stability of cervical vertebrae.The iliac crest autogragt is more characterized than Ti-alloy mesh on the fusional time,the changes of intervertebral height,the lost physio-curve.There are no unique virtue on Ti-alloy mesh,so the indications should be grasped strictly.