颈椎前路Solis固定与钛板固定的对比研究

目的比较颈椎前路减压植骨钛板固定和 Solis固定的疗效.方法 2001年9月～2004年3月,收治颈椎病患者104例,其中采用前路减压Solis固定36例,年龄31～69岁;减压植骨钛板固定68例,年龄35～72岁.术后6周,3、6、12、24及36个月,采用JOA评分法评定神经功能恢复情况,并摄X线片观察融合节段情况、稳定性及椎间高度改变.结果 Solis固定组手术时间短、出血量少,且无并发症,与钛板固定组比较差异有统计学意义(P＜0.05).术后JOA评分Solis固定组优良率94.4%,钛板固定组为94.1%.两组患者X线片示手术节段均在3个月内骨性融合,Solis固定组椎间高度增加1.6±0.7 mm,与钛板固定组1.4±0.6 mm比较,差异有统计学意义(P＜0.05).两组融合节段Cobb角改变均<5°, Solis固定组为3.6±0.8°,钛板固定组为2.4±0.7°,且两组比较差异有统计学意义(P＜0.05).结论两种内固定术的临床疗效均良好,但Solis操作更简便,创伤小、并发症少.

COMPARISON BETWEEN SOLIS FIXATION FUSION AND TITANIUM PLATE FIXATION BY CERVICAL ANTERIOR APPROACH

OBJECTIVE: To investigate the effect difference between the Solis fixation fusion and the titanium plate fixation by the cervical anterior approach after decompression and bone graft implantation. METHODS: Of the 104 patients with cervical disease from September 2001 to March 2004, 36 were treated with the Solis implantation after decompression by the cervical anterior approach, and 68 were treated with the titanium plate fixation after decompression and bone graft implantation. The recovery of the neurological function in all the patients were assessed with the JOA Scoring at 6 weeks, 3, 6, 12, 24 and 36 months. The fragment fusion and its stability as well as the changes in the intervertebral height were assessed with X-ray examination. RESULTS: According to the JOA Scoring, the excellent and good outcomes accounted for 94.4% in the Solis group and 94.1% in the titanium plate group. In all the patients, the fragment fusion was achieved in 3 months. The change in the Cobb angle of the fused fragment was less than 5 degrees at the flexion-extension posture, 3.6 +/- 0.8 degrees in the Solis group, 2.4 +/- 0.7 degrees in the titanium plate group. There was significant differences between the two groups (P < 0.05). The intervertebral height of the operation fragment in the Solis group increased 1.6 +/- 0.7 mm, which was higher than that in the titanium plate group (P < 0.05). CONCLUSION: Clinical effects of the two internalfixation operations are good; however, the Solis fixation has more advantages because of its simpler performance, less trauma, and fewer complications.