一体成型式皮质骨生物型颈椎椎间融合器在颈前路融合术中的应用

目的 探讨一体成型式皮质骨生物型颈椎椎间融合器应用于颈前路融合术的临床疗效.方法 2005年8月至2007年1月对15例颈椎病患者行前路减压一体成型式皮质骨生物型颈椎椎间融合器置入钢板内固定术,男12例,女3例;年龄45～68岁,平均54.6岁;颈椎创伤4例,退变性11例,病变节段C3-4 2例,C4-5 6例,C5-6 7例C6-7 3例;1个节段11例,2个节段4例.颈椎不稳5例,神经根型6例,脊髓型4例.术后对比手术前后椎间隙高度、颈椎前凸Cobb角,判断术后颈椎间融合情况.结果 15例患者术后获15～24个月(平均18.4个月)随访,术后即刻及末次随访时椎间隙高度和颈椎前凸Cobb角与术前相比明显改善,差异均有统计学意义(P<0.05);术后椎间隙高度和颈椎前凸cobb角与末次随访时比较,差异无统计学意义(P>0.05);日本骨科协会(JOA)评分:末次随访时与术前比较差异有统计学意义(P<0.05).随访期间15例患者X线片均示椎间融合,融合时间为3～6个月,平均4.2个月.结论 一体成型式皮质骨牛物颈椎椎间融合器可辅助维持脊椎的生理弧度和椎间隙的高度,提供颈椎初始及中期的稳定性,以实现椎问骨性融合及便于判断椎间融合情况.

Clinical application of integrated cortical bone biological cervical fusion cage in 15 cases

Objective To evaluate clinical effects of the integrated cortical bone biological cervical fusion cage(ICBBCFC)used in the anterior cervical interbody fusion. Methods We designed the ICBBCFC.Fifteen patients with cervical spondylosis were treated by anterior decompression,implantation of ICBBCFC and plate fixation.X-rays were taken pre and post-operatively and the movement of spinous process,trabecula of bone,and radiolucent zone were observed.The intervertebral heights and lumbar lordosis changes were monitored so as to observe the fusion cage synostosis.Results Follow-ups for an average of 18.4 months(15 to 24 months)revealed that all patients achieved bone fusion.The intervertebral heights at the immediate postoperation and the last follow-up were significantly increased compared to the preoperative values (P<0.05),but there were no significant changes between the immediate postoperation and the last follow-up (P>0.05).The same was true with the changes in lumbar lordosis(Cobb angle). Conclusions The ICBBCFC can help maintain the physiological vertebral lordosis and intervertebral height,providing initial and middle stability to achieve bone fusion.It may a1so make it easier to eva]uate the fusion conditions.