颈椎前路不同术式对颈椎术后即刻稳定性的影响

目的评价颈椎前路单节段椎间盘髓核切除术后,颈椎间融合器(cage)植入和颈椎间植骨加颈前路钛板内固定的稳定性。方法取8具山羊颈椎标本(C2~C7),先后制成:C4/C5椎间盘髓核切除、C4/C5Solis颈椎间融合器(cage)植入、C4/C5椎间植骨加颈前路钛板内固定模型。在非破坏方式下依次检测和评价颈椎在前屈、后伸、左侧弯方向的载荷及移位情况,计算位移-载荷均值并绘图比较。结果C4/C5椎间盘髓核切除后颈椎的前屈运动增加40%(P<0.05),后伸运动增加31%(P<0.05),侧弯运动增加32%(P<0.05);C4/C5Solis颈椎融合器(cage)植入和C4/C5椎间植骨加颈前路钛板内固定后各方向运动均明显减少,增强了这三个方向上的稳定性。结论在单节段颈椎前路手术时,椎间植骨加颈前路钛板内固定和Solis颈椎间融合器(cage)植入均能够提供良好的颈椎稳定性,但后者有利于减少术后并发症,故基本可以替代钛板内固定方法。

Effect of different methods of anterior cervical surgery on postoperative instant stability

Objective To evaluate the biomechanical stability of the cervical spine with single-level discectomy followed by cervical vertebra fusion with Solis cage and anterior plate in goat cervical models. Methods Eight goat cervical specimens from C2-7 were used to establish models in order as below: C4,5 discectomy, C4 to C5 fusion with Solis cage, intervertebra graft and fusion between C4 to C5 and anterior plating stabilization. Non-destructive test was used to assess the loading and translation of the cervical spine in flexion, extension, side bending. Mean value of displacement/load was calculated and compared. Results It showed that the flexion motion after C4,5 discectomy was increased by 40%(P<0.05),The extension motion was increased by 31%(P<0.05),And the side bending was increased by 32%(P<0.05).The three dimensional movements were decreased obviously following cervical vertebra fusion with Solis cage and anterior plate, which increased the stability of the cervical spine when moving in the three direction. Conclusion Both intervertebra graft combined with anterior plate interfixation and intervertebra Solis cage inplacement can obtain good stability. Due to less postoperative complication of the latter, the cage inplacement can replace the anterior plate stabilization.