单间隙颈椎前路减压单纯植骨融合与加用钢板的疗效比较

目的：对单间隙颈椎前路减压后有无必要在单纯植骨基础上加用钢板内固定作一初步探讨。方法：对48例单间隙病变行前路减压手术的患者随访1－4年，平均2．2年。根据症状改善情况及影像学资料对单纯植骨和加用前路钢板内固定作分析比较。结果：根据JOA评分，单纯植骨组和加用钢板内固定组之间在疗效的改善方面近似，都能获得满意的融合率；在椎间高度的恢复和维持方面加用前路钢板有明显效果（P＜0．05），在恢复和维持颈椎生理曲度方面，加用钢板也优于单纯植骨。结论：使用前路钢板安全、可靠，在单间隙病变手术中加用前路钢板有助于恢复和保持颈椎生理曲度，防止植骨块的塌陷，可能利于长期手术疗效的保持。

The comparison between single-level anterior decompression and fusion with and without cervical plating

Objective:To compare the clinical and radiographic results of single level discectomy performed with and without anterior cervicl self locking plate(ACLP) fixation.Method:48 patients suffered from single level cervical spondylotic myelopathy were treated surgically with anterior decompression and autogeneous graft fusion. 28 patients had ACLP (group B), whereas 20 had no plates (group A).Result:Based on JOA evaluation,both groups achieved satisfactory results and there was no significant difference between the two groups.There was one pseudarthrosis in group A, and in group B all patients achieved solid fusion. The average loss of lordotic curve of the fused segment was 1 0 degree with plating and 1 4 degree without plating ( P =0 057),close to significance.The amount of graft collapse for patients with plating was 0 75mm compared with 1 6mm without plating ( P =0 034).Conclusion:Addition of ACLP fixation for single level anterior decompression and fusion can be more effective to prevent graft collapse. This procedure is safe, effective and not assosiated with pseudarthrosis rate.