三种颈椎前路内固定装置对术后脊柱稳定性的作用

目的探讨颈椎前路带锁钢板在颈椎前路减压术中维持脊柱的稳定性的应用价值。方法对47例颈椎前路减压植骨内固定患者犤Orion30例,Zephir11例,一体化颈椎前路钢板-融合器系统(PCB)6例犦术后进行7～26个月(平均15个月)随访。结果26例患者术前有椎间隙狭窄,18例有颈椎生理前突改变,手术后均获得满意的椎间隙高度重建,随访中未见明显椎间隙高度丢失,手术矫正的生理曲度保持良好。43例患者神经功能获得不同程度的恢复,其余4例无明显神经功能恢复者均为创伤后完全截瘫患者。结论PCB适用于急性椎间盘突出或单节段脊髓型颈椎病;Zephir与Orion钢板适用于颈椎多节段病变及致压物广泛的单节段病变,利于颈椎生理曲度和椎间隙高度的恢复。

The use of three kinds internal fixators in improving spinal stability postoperatively

Aim To evaluate the clinical val ue of two cervical spinal locking plates,Orion and Zephir,an d a new anterior c ervical instrument al system combining an intradiscal cage with an integrated pl ate(PCB)after anterior cervical decompression su rgery.Methods 47patients w ere followed up for 7-26months with an average of 15months after surgery. Of them,30were treated with Orion,11with Zephir and another 6with PCB.Re sults26cases with preoperative interverte bral space constriction and 18case s with changes of cervical physiological p rotrusion all achieved satisfying e f fect of rebuilding intervertebral space height after operation.The cases with o bvious intervertebral space height loss we re not seen after follow up.The phys io-logical curvature corrected by operation was well kept.Neurological fu ncti on was improved in 43cases on different extent after operation.The other 4c ases with no obvious recovery of neu rological function were all that wit h comp lete paraplegia after trauma.Conclusion PCB is suitable for treatment of the a cute cervical protrusion or t he cervical spondylotic myelopathy at one level.Z ephir and Orion are suitable to all kinds of cervical vertebra lesions at more t han one level and complex lesio n at one level,which helps the re-covery of ce rvical physiological cu rvature and height of disc space.