颈前路钢板系统在颈椎肿瘤手术中的应用

目的：探讨颈椎前路带锁钢板系统在颈椎肿瘤手术治疗中的应用价值。方法：对8例颈椎肿瘤患者采取前路椎体切除术、自体髂骨植骨以及颈椎前路带锁钢ORION内固定手术治疗。结果：8例患者得到8-21个月随访,平均12．5个月,2．9～4．3个月内所有植骨均骨性融合,平均融合时间3．4个月,瘫痪患者神经功能均有不同程度恢复,1例术后出现短暂声嘶,1例术后出现吞咽困难,无钢板螺钉断裂、松动或脱出及其他并发症。结论：颈椎前路带锁钢板系统在手术切除颈椎椎体和肿瘤后能提供即刻稳定性,有利于促进神经功能的恢复。     

颈椎前路钢板在脊髓型颈椎病前路手术中的作用

目的 评价内固定在脊髓型颈椎病前路减压中的作用。方法 143例脊髓型颈椎病患者经前路减压后自体髂骨植骨，带锁钢板内固定。获得随访病例132例，随访时间平均20个月，观察术后神经功能恢复情况，植骨融合率，椎间高度及颈椎生理曲度恢复情况。结果 单节段与两节段病变者术后3月均获得骨性愈合，融合率为100％，16例3节段病变者融合体为81．3％，内固定并发症为5／132(3．8％)。术后椎间高度与生理曲度均获得满意重建。JOA记分平均改善率65．8％。结论 在脊髓型颈椎病前路减压手术中应用带锁钢板内固定可有效维持椎间高度和生理曲度，并有助于后路间接减压。     

Orion锁定型颈椎前路钢板在颈前路手术中的应用

目的　研究和评价 Orion锁定型颈椎前路钢板系统 (anterior cervical locking platesystem ,ACL PS)在颈前路手术中的价值和作用。方法　对 15例颈椎疾病患者均行颈椎体次全切除术 植骨术 ,并采用 ACL PS内固定。结果　 15例中 12例获随访≥ 6个月。所有病例植骨均完全愈合 ,无一例发生钢板螺钉松动、断裂等并发症 ,病人症状均有不同程度的改善。结论　 ACL PS操作简单 ,固定牢固 ,特别适用于在颈前路手术中的应用     

一体化钢板前路系统在颈椎前路手术中的应用

目的：对29例颈椎疾病患者应用一体化颈椎前路钢板和支架系统（A new anterior cervical instrumental system combining an intradiscal cage with and integrated plate,PCB)的临床疗效进行评估。方法：切除椎间盘后，显露硬膜，神经根减压。选择合适型号的PCB，置入椎间隙固定。结果：29例病人中，颈椎病19例，颈椎间盘突出症10例，男性20例，女性9例，平均年龄42岁（29－61岁），随访时间为3－16个月，23例病人接受了1个节段的固定，6例病人2节段，该技术易于掌握和应用，无术中并发症及螺钉脱出或固定失败，25例病人临床症状明显改善，4例症状轻度改善，系合并较严重的颈椎管狭窄所致，总优良率86．2％，结论：PCB椎间固定稳固，供骨和植骨部位并发症少，术后不需戴颈托。     

Window钢板系统在颈椎前路手术中的应用

颈椎前路减压效果已被临床证实 ,但植骨融合失败所造成的严重后果使该术式的应用受到限制。我们自 1998年 6月开始应用Ｗｉｎｄｏｗ钢板固定减压节段及植骨块 ,效果满意 ,报告如下 :1　临床资料1 1　一般资料　本组 12例 ,男 9例 ,女 3例 ;年龄 2 8～ 67岁 ,平均 42 5岁。疾病分类 :颈椎病 6例 ,颈椎ＯＰＬＬ1例 ,颈椎外伤 5例 ;神经功能Ｆｒａｎｋｅｌ分级 :Ｂ级 1例 ,Ｃ级 2例 ,Ｄ级 7例 ,Ｅ级 2例 ;融合节段 :单节段 5例 ,双节段 7例。1 2　内固定材料　该钢板为美国Ｏａｋｌａｎｄ公司生产 ,由钛合金材料制成。钢板长度为 2 6～ 70ｍｍ…     

颈椎前路手术ZEPHIR钢板内固定临床应用

目的探讨ZEPHIR钢板在前路手术中应用的价值。方法28例颈椎疾病患者行颈椎前路手术及ZEPHIR钢板内固定，其中颈椎骨折脱位16例，颈椎间盘突出12例。结果28例中26例随访4～15个月，1例14个月后钢板下极螺钉松动，余25例钢板螺钉固定位置良好，植骨块无移位，26例均已达骨性融合。结论ZEPHIR钢板有优良植入物设计和力学性能，可获得术后颈椎即刻稳定，防止植骨块移位，无需外固定，能显著提高植骨融合率。     

颈前路减压带锁钢板内固定治疗下颈椎损伤（附51例报告）

下颈椎是指C3～7，包括C7～T1的连接部位。颈椎损伤指的是颈椎外伤后颈椎骨折脱位或颈椎问盘突出，常合并脊髓及神经根受压或损伤。自1999年1月～2002年6月应用颈前路减压、植骨及带锁钢板内固定治疗下颈椎损伤54例，取得良好效果。报告如下。     

颈椎前路带锁钢板内固定治疗颈椎骨折并四肢瘫痪

目的：分析颈椎前路带锁钢板内固定治疗颈椎骨折并四肢瘫痪的临床治疗效果。方法：对21例颈椎骨折并四肢瘫痪的患者施行颈椎前路减压、植骨及颈椎前路带锁钢板内固定术。术后定期X线片观察损伤节段的稳定性和融合率以及有无内置物并发症，以Frankle分级判定脊髓功能恢复情况。结果：20例获得随访，时让12～32个月。平均19．3个月。20例患者均取得满意疗效，损伤节段稳定，植骨愈合良好，无内置物并发症，脊髓功能平均提高1．75级。结论：颈椎前路带锁钢板内固定治疗颈椎骨折并四肢瘫痪，能使损伤节段获得稳定性，方便护理和功能锻炼，辅以其他措施则能促进脊髓功能的恢复。     

Reflex颈前路钢板系统在颈椎伤病手术中应用的特点

随着我国老龄人、伏案工作人数以及交通事故伤、建筑工伤的增多,颈椎伤病患者特别是需要手术治疗的颈椎伤病患者逐渐增多。颈前路钢板是被广泛应用于颈椎间盘切除和椎体切除后重建颈椎稳定性的内固定系统,临床上用于治疗颈椎创伤、畸形、退变性椎间盘疾病和肿瘤等疾病。我院从2003年1月~2004年10月在颈椎前路手术中应用Reflex颈前路钢板系统行颈椎内固定术,治疗了21例颈椎伤病患者,取得满意效果。1资料与方法1.1临床资料我院自2003年1月~2004年9月采用美国Stryker公司设计制造的Reflex颈前路钢板系统治疗颈椎骨折合并高位截瘫和脊髓型颈椎…     

四种颈椎前路钢板在颈椎融合手术中应用和比较

目的：观察和比较4种颈椎前路钢板在颈椎前路融合手术中的优点和不足。方法：101例颈椎病、颈椎后纵韧带骨化症(OPLL)无骨折脱位型颈髓损伤患者进行前路椎间盘减压、植骨融合同时分别采用AO、Caspar、Orion和Zephire颈椎前路固定系统固定。与单纯植骨融合组比较手术时间、出血量、术后并发症、术后症状体征缓解程度和融合情况。结果：患者症状特征术后明显改善；未发现手术并发症，颈椎前路钢板固定组融合率明显优于单纯植骨融合组。结论：4类钢板均能提供充分的颈椎稳定性，使用安全，Zephire钢板较其余钢板系统使用更为简便。     

Orion钛板在颈脊髓损伤中的应用

目的：探讨Orion钛板在颈脊髓损伤手术中的应用价值。方法：采用Orion钛板对46例颈脊髓损伤患(部分配合应用Pyramesh钛网)行颈前路减压、植骨(原位／髂骨)融合，内固定。结果：46例患中43例获得随访，时间为1．5～28月，32例≥6月，10例≥3月，1例≥1．5月。41例已获骨性愈合，术后椎间高度及生理弯曲维持满意，无一例发生植入物并发症．结论：采用Orion钛板行颈脊髓损伤椎间融合能充分保证固定阶段的稳定性，植骨愈合率高，有效地维护了伤椎椎间高度和生理曲度，在颈脊髓损伤中有较大的应用价值，远期疗效还有待于进一步观察。     

Clinical Efficacy Analysis of the New PRUNUS Spine Plate System for Anterior Cervical Spine Surgery

Objective

Although the role of anterior cervical titanium plate system in stabilizing the spine sequence and promoting bone graft fusion has been widely recognized, more and more attention has been paid to the design of the plate itself and the complications caused by it. In order to solve the problems of poor stability of internal fixation, plate displacement and screw looseness, we designed the new PRUNUS spine plate system. Hence, the present study was conducted to describe observe and evaluate the clinical efficacy of a new type of three-leaf reinforced cervical anterior screw plate system (PRUNUS nailing system) developed for anterior cervical surgery.

Methods

A retrospective analysis of 56 patients from June 2018 to October 2019 was used. Twenty-seven patients with cervical spine disease treated with new PRUNUS nail plate internal fixation were selected as the observation group, and 29 patients with cervical spine disease treated with conventional cervical anterior screw fixation were selected as the control group. Postoperative follow-up was performed. Cervical stability, internal fixation position and bone graft fusion were evaluated according to imaging data. The operative time, intraoperative blood loss, cervical Cobb angle, pain visual analogue scale (VAS), and Japanese orthopaedic association (JOA) were compared between the two groups. Spinal function scores and neurological improvement rates were used to evaluate the clinical efficacy of the new PRUNUS spine plate.

Results

The patients were followed up for 5–18 months, with an average of 7.33 months. The average operative time of the observation group was 98.4 ± 9.2 min, and the mean intraoperative blood loss was 65.3 ± 10.6 ml, which were significant different from the control group's 109.7 ± 9.4 minutes (P < 0.05), 72.9 ± 15.6 ml (P < 0.05). Comparison between the two groups in postoperative and final follow-up of cervical Cobb angle, JOA score and improvement rate, VAS score and preoperative comparison showed no significant differences (P > 0.05).

Conclusion

The new PRUNUS spine plate system can be applied to the anterior cervical spine surgery, and its clinical efficacy was similar to the traditional cervical anterior plate. But PRUNUS simplified the operation process, especially suitable for the surgical treatment of anterior cervical revision and osteoporosis patients.     

颈椎前路手术ORION钢板内固定46例报告

目的　探讨Orion钢板在颈椎前路手术中的应用价值。方法　 46例颈椎疾病患者予行颈椎前路手术及Orion钢板内固定 ,其中颈椎骨折脱位 9例 ,颈椎间盘突出及颈椎病 34例 ,颈椎肿瘤 2例 ,颈椎结核 1例。结果　 46例中 33例随访 3～ 13个月 ,平均随访 7个月 ,1例钢板下极螺钉松动 ,余 32例钢板螺钉固定位置良好 ,植骨块无移动 ,均已达骨性融合。结论　Ori on钢板有较优的材料和力学性能 ,内固定于颈椎体前有维持术后近期颈椎生理前凸 ,稳定植骨块 ,利其达到骨性融合 ,防止颈椎间隙高度丢失作用     

颈椎前路钢板位置与术后颈肩痛的相关性影响

目的观察颈椎前路钢板内固定术后颈肩痛与钢板位置之间的关系。方法回顾分析1999年8月~2006年7月间实施的219例颈椎前路钢板内固定手术的临床和影像学资料。分别观察颈椎侧位X线片上钢板在上下位椎体的覆盖率,正位X线片评估其侧方移位和成角,应用视觉模拟评分(VAS)、颈椎活动障碍指数(NDI)评价手术前、后颈肩痛。应用Pearsons相关系数、线性回归分析进行统计学分析。结果平均随访16.8个月(6~42个月),钢板侧方偏移和成角与术后颈肩痛高度相关(相关系数P=0.417,P<0.001,n=87),线性回归分析显示钢板偏移和成角与术后VAS评分高度正相关(相关系数P=0.314,P<0.001,n=82),与术后NDI成正相关(相关系数P=0.379,P<0.001,n=66)。结论颈椎前路钢板侧方偏移和成角是术后颈肩痛的原因之一,术中应注意调整钢板位置,尽量避免侧方偏移和成角。     

Cost Advantages of Two-Level Anterior Cervical Fusion with Rigid Internal Fixation for Radiculopathy and Degenerative Disease

Background

Conventional anterior cervical discectomy with fusion is thought to require postoperative neck immobilization for the promotion of bony fusion. Rigid internal fixation with anterior cervical plates may decrease graft-related complications and provide immediate stability. This stability may obviate postoperative external immobilization.

Methods

This report reviews one surgeon’s experience with the use of rigid internal fixation for two-level anterior cervical discectomy and fusion for radiculopathy to promote early mobilization without external bracing. It compares outcomes and costs with a similar population of patients treated with anterior cervical discectomy and fusion who did not undergo rigid internal fixation. We compared patients who underwent two-level allograft anterior cervical discectomy and fusion with or without rigid internal fixation between 1989 and 1994 performed by a single surgeon (FJP) to evaluate the cost advantages and outcome of each procedure. All patients had clinical evidence of cervical radiculopathy unresponsive to medical therapy with magnetic resonance imaging confirmation of the appropriate nerve root impingement. Thirty-nine patients underwent two-level Cloward allograft fusion using Synthes anterior cervical locking plates, 25 underwent identical fusion without plating. Follow-up was 6 months to 4 years (mean, 31 months).

Results

Twenty-three of 25 patients in the nonplated group and 36 of 39 patients in the plated group achieved excellent or good outcomes using the Odom criteria. There were six complications (two major and four minor) in each group. Patients who underwent plating returned to light activities (mean, 17 vs. 29 days), driving (28 vs. 57 days), and unrestricted work (66 vs. 136 days) sooner than nonplated patients (p < 0.05, paired t test). No patient with plates was given external immobilization.

Conclusions

Two-level anterior cervical discectomy and fusion with anterior plating for radiculopathy is safe, effective, and seems to provide shorter convalescence compared with conventional anterior cervical discectomy and fusion. Patients returned to unrestricted work sooner, thus reducing short-term disability. Rigid internal fixation may provide cost advantages to patients and insurance disability providers. The authors conclude that the increased cost of treatment for rigid internal fixation is more than offset by the benefits of earlier mobilization.     

颈前路带锁钛板在脊髓型颈椎病手术中的应用

目的评价脊髓型颈椎病前路减压后应用带锁钛板内固定的价值。方法对51例脊髓型颈椎病患者采用前路减压、取自体髂骨植骨和颈椎带锁钛板内固定治疗。结果随访43例,平均随访时间2a,术后3个月植骨块获得骨性融合,颈椎椎间高度和生理曲度维持满意,感觉、肌力明显恢复,钛板及螺钉无松动及断裂现象。结论脊髓型颈椎病前路减压术后应用带锁钛板内固定能促使植骨块融合,有效地维持椎间高度和颈椎生理曲度,有较高的应用价值。     

应用AXIS侧块钢板螺钉内固定系统治疗下颈椎骨折脱位

目的 探讨AIXS侧块钢板螺钉系统在下颈椎骨折脱位中的应用。方法 对29例下颈椎骨折脱位患者进行AIXS后路侧块钢板螺钉系统固定,随访其内固定、骨融合和脊髓功能恢复情况。结果 全部病例得到随访,随访期平均13个月。所有患者术中未出现与内固定有关的并发症,术后无螺钉松动、移位和断裂。29例患者均在3～6个月获得骨性融合。脊髓功能有不同程度恢复。结论 AXIS侧块钢板内固定系统具有稳定性好、操作相对安全、方便的特点,是下颈椎后路内固定的良好选择。