颈椎前路手术后翻修术

目的:对颈椎前路手术后翻修术的适应证和手术方式进行探讨,评价前路内固定在颈椎翻修术中的应用价值。方法:我院1998~2002年有43例颈椎前路手术后患者进行了翻修术,重新从前路行减压、植骨及内固定。分析其翻修原因、临床表现、手术方式及术后疗效,并对术前、术后及随访时的影像学资料进行测量及评价。结果:因并发食道瘘死亡1例,失访2例,40例获得1~4年(平均33个月)随访,除2例因假关节形成融合失败外,其余38例均获牢固骨性融合,术后12周内融合者24例,12～24周内融合者14例。术前与术后即刻、术前与术后随访时“D”值有显著性差异(P<0.01);术后即刻与术后随访时“D”值无显著性差异(P>0.05)。结论:颈椎前路翻修术在临床疗效、恢复和维持颈椎生理曲度方面效果满意。

Anterior cervical spine revision and the outcome observation

Objective:To discuss the indication and methods of anterior cervical spine revision,and evaluate the values of anterior locking plate systems of anterior cervical spine revision.Method:43cases of anterior cervical spine revision in our hospital from1998to2002treated with anterior decompression,bone grafting and internal fixation were included.The reasons of revision,clinical manifestations,operation methods and post-operative outcome were discussed.Radiographs in both preoperation and follow-up were also measured and e-valuated.Result:Among those43cases,one died of gullet fistula,2lost from follow-up,40got1~4years fol-low-up(the mean follow-up33months).38of40follow-up patients got solid fusion except2which were de-termined as fusion failure because of pseudarthrosis.24cases fused in12weeks postoperatively,14cases fused in12~24weeks.There were significant differences between the preoperative and the immediate postoperative,between preoperative and follow-up groups in D numerical value(P<0.01).There were no significant differences in D numerical value(P>0.05)between immediate postoperative and follow-up groups.Conclusion:Anterior cer-vical spine revision is satisfied in clinical outcome and effect of recovering and maintaining the lordosis of cervical spine.