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1、頸前路鈦板加鈦網(wǎng)固定術(shù)后早期穩(wěn)定性的觀(guān)察作者:周盛源,張立巖,王濟(jì)緯,魏堯森,陳日勇,徐建軍摘要:目的觀(guān)察半限制型鈦板加鈦網(wǎng)在頸椎前路減壓融合術(shù)后早期的穩(wěn)定性。方法對(duì)52例確診為頸椎病的患者進(jìn)行頸椎前路單椎體次全切減壓融合術(shù),均用半限制型鈦板(CSLPVA或ZEPHIR頸前路鋼板)固定,其中22例行鈥網(wǎng)植骨,30例行自體髂骨塊植骨。術(shù)前、術(shù)后分別攝正側(cè)位、動(dòng)力位X線(xiàn)片,觀(guān)察鈦網(wǎng)、植骨塊、鎖定鋼板系統(tǒng)有無(wú)塌陷、松動(dòng)等不穩(wěn)定情況。對(duì)術(shù)后2個(gè)月以?xún)?nèi)二者穩(wěn)定的差異行x2檢驗(yàn)。結(jié)果術(shù)后2個(gè)月以?xún)?nèi),22例行鈦網(wǎng)植骨融合病例中出現(xiàn)不穩(wěn)定的有6例,30例行自體髂骨塊植骨融合病例中出現(xiàn)不穩(wěn)定的有1例
2、。用x2值進(jìn)行連續(xù)校正檢驗(yàn),說(shuō)明髂骨植骨塊和欽網(wǎng)治療在術(shù)后2個(gè)月內(nèi)穩(wěn)定性的差異有統(tǒng)計(jì)學(xué)意義(P<)。術(shù)后2個(gè)月以后未見(jiàn)新增不穩(wěn)定病例,經(jīng)6?18個(gè)月(平均個(gè)月)隨訪(fǎng),所有病例均獲得融合。結(jié)論半限制型鈦板加鈦網(wǎng)內(nèi)固定治療頸椎病,在術(shù)后早期較易發(fā)生鈦網(wǎng)塌陷和半限制型鈦板固定系統(tǒng)松動(dòng)。關(guān)鍵詞:頸椎??;鈥板;鈥網(wǎng);穩(wěn)定性StudyofEarlyStabilityafterACDFwithDynamicPlatesandTitaniumSurgicalMeshAbstract:ObjectiveTostudytheearlystabilityoffuseonsegmentafteranter
3、iorcervicaldecompressionandfusion(ACDF)withthetitaniumsurgicalmeshanddynamicplates.Methods52casesofcervicalspondylosistreatedwithonelevelanteriordecompression,fusionandinternalfixationwithdynamicplates(AOCSLPVAorZEPHIRplate)wereincluded,22caseswithtitaniumsurgicalmesh,30caseswithiliacboneautog
4、raft.Preoperative,immediatepostoperativeandpostoperativeradiographsweretaken,theinstability(subsidenceand/orloosing)oftitaniumsurgicalmesh,iliacboneanddynamicplateswereobserved,andtheresultduringfollowup2monthswascomparedstatisticallywithx2test(chisquaretest).Results6caseswithtitaniumsurgicalm
5、eshandlcasewithiliacboneautograftwereinstabilitywithin2msinrestoringonths.ThereweresignificantdifferenceearlystabilityafterACDF(P<).Nofurtherinstabilitywerefoundinallcasesafter2months.Through618months(monthsinaverage)followedup,allcasesobtainedsolidfusion.ConelusionDynamicplateswithiliacboneau
6、tograftisbetterthantitaniumsurgicalmeshinrestoringearlystabilityoffusionsegment.titaniumsurgicalmesh;stability隨著對(duì)頸椎病的進(jìn)一步認(rèn)識(shí)和手術(shù)器械、材料的發(fā)展,頸椎病的手術(shù)治療方法逐漸被廣泛的接受。頸椎前路減壓融合術(shù)因其減壓徹底、對(duì)頸椎活動(dòng)影響小、手術(shù)成功率高、效果良好,已在我院開(kāi)展多年。目前鈦網(wǎng)已在頸椎前路減壓融合術(shù)中廣泛應(yīng)用,頸前路鎖定鋼板加鈥網(wǎng)治療頸椎病的療效已得到廣泛認(rèn)可。我們?cè)赬X年開(kāi)始應(yīng)用頸前路半限制型鈦板,如CSLPVA、ZEPHIR頸前路鋼板和鈦網(wǎng)治療部分頸椎
7、病患者。從術(shù)后隨訪(fǎng)的情況,通過(guò)與自體髂骨塊加半限制型鈦板在頸椎前路減壓融合術(shù)后早期穩(wěn)定性的臨床觀(guān)察對(duì)比,來(lái)了解半限制型鈦板加鈦網(wǎng)臨床治療頸椎病的價(jià)值。1資料和方法病例選擇選用XX年1月至XX年10月在本院確診的頸椎病病例,其中行頸前路單椎體次全切減壓融合術(shù),用頸前路半限制型鈥板(ZEPHIR或CSLPVA內(nèi)固定系統(tǒng))[1]治療患者共63例,隨訪(fǎng)共52例。其中22例行鈥網(wǎng)植骨融合,男10例,女12例;年齡35?80歲,平均56歲;C4次全切6例,C5次全切10例,C6次