选择性连续三节段椎间融合器置入对脊髓型颈椎病患者颈椎曲度的长期影响

目的:评价选择性颈椎前路三节段椎间融合术治疗脊髓型颈椎病对颈椎曲度的长期影响。方法:应用Solis融合器行选择性连续三节段颈前路手术治疗脊髓型颈椎病共25例,C3/4/52例,C4/5/6 8例,C5/6/714例,C6/7/T11例,共75个椎间隙。所有患者均随访2年以上。收集术前、术后6个月及术后2年的Borden法颈椎前曲度数据及颈椎Japan orthopedics association(JOA,17分法)评分予以统计学分析。结果:出血量20~80 ml,平均37 ml,手术时间100~175 min,平均118 min。平均随访31.3 ms,手术节段均骨性融合,无植入物移位或椎体塌陷。术前JOA评分(10.31±3.44)分,术后6个月(16.72±1.36)分,术后2年(15.59±1.71)分;术前颈椎曲度均值为(1.82±3.13)mm,术后6个月为(4.59±1.68)mm,术后2年为(4.38±2.25)mm。以上各组数据术前与术后6个月,术前与术后2年间差异均有统计学意义(P<0.05),术后6个月与术后2年间差异均无统计学意义(P>0.05)。结论:行颈椎前路连续三节段椎间融合器植术治疗脊髓型颈椎病可有效改善颈椎曲度并长期维持,有良好的临床疗效。

Long-term influence of selective consecutive three-level appliance of intervertebral cage on cervical curvature for spondylotic myelopathy

Objective Evaluation of the long-term effects of selective anterior cervical three mtervertebral fusion for cervical spondylosis myelopathy on cervical curvature.Methods A total of 25 patients with selective continuous three segmental anterior cervical operation for treatment of cervical spondylotic myelopathy combined application of Solis,C3/4/5 in 2 cases,C4/5/6 8 cases,C5/6/7 14 cases,C6/7/T1 1 cases,a total of 75 intervertebral space. All patients were followed up for more than 2 years.Collected preoperatively,6 months after surgery and postoperative Borden cervical 2 years before the curvature data and cervical Japan orthopedics Association（JOA,17 points） score for statistical analysis.Results The blood loss ranged from 20 to 80 ml,average 37 ml,operation time of 100- 175 min,average 118 min.The average follow-up was 31.3 ms,operation segmental bony fusion,no implant migration or vertebral body collapse.Preoperative JOA score （10.31 ± 3.44）%,6 months after operation （16.72 ± 1.36）%,2 years after operation （15.59 ± 1.71）;preoperative cervical curvature mean （1.82 ± 3.13）mm,at 6 months after operation （4.59±1.68）mm,afler 2 years as （4.38±2.25）ram.The above data of each group before operation and 6 months alter surgery, preoperative and postoperative 2 years the differences were statistically significant （P 〈 0.05）,postoperative difference 2 years 6 months and after operation there was no statistical significance（P 〉 0.05）.Conclusion Anterior cervical continuous three intervertebral fusion cage in the treamaent of cervical spondylosis myelopathy can effectively improve the cervical curvature and long- term maintenance,have a good clinical effect.