【摘要】 目的比较Solis融合器与自体髂骨块植骨联合钛板治疗单节段脊髓型颈椎病的疗效,并探讨Solis融合器的适应证选择和应用注意事项。方法回顾性分析自2008-01—2012-06行手术治疗且资料完整的39例单节段脊髓型颈椎病,行颈前路减压植骨融合术(ACDF),其中使用Solis融合器植骨融合者为A组(n=19),使用自体髂骨块植骨联合钛板内固定者为B组(n=20);2组性别比、年龄、病程、术前JOA评分及手术节段分布比较,差异均无统计学意义。比较2组手术时间、术中出血量、平均住院时间、术后JOA评分及JOA改善率、椎间融合率和并发症发生率。结果所有患者获得随访22~45个月,平均32个月。术后症状改善率和融合率2组比较差异均无统计学意义(P>0.05)。A组1例发生融合器下沉,B组1例术后取骨区血肿形成、2例术后1年发生取骨处疼痛、2例术后发生吞咽困难,2组并发症发生率差异有统计学意义(P<0.05)。结论应用Solis融合器和与自体髂骨块植骨联合钛板治疗单节段脊髓型颈椎病均可取得较好的疗效,Solis融合器操作简便、术后并发症发生率较低,但对于严重骨质疏松的患者,不宜单独使用Solis融合器。更多还原

【Abstract】 Objective To study clinical outcomes of anterior cervical discectomy and fusion(ACDF) using Solis cage vs. iliac bone graft with anterior plating in treatment of the single level cervical spondylotic myelopathy, and explore the indications and safety of application of Solis cage. Methods The clinical data of 39 patients with single level cervical sponylotic myelopathy who underwent anterior cervical discectomy and fusion(ACDF) by Solis cage(group A, n =19) or iliac bone graft with anterior plating(group B, n =20) between January 2008 and June 2012 were retrospectively analyzed. There was no statistical significance in the gender, the age, the pathogenesis, preoperative JOA scores and the surgical level between two groups(P >0.05). The operation time, intraoperative blood loss, inpatient stay, postoperative JOA scores and JOA recovery rate,fusion rate and complication rate in both groups were measured and compared. Results All patients were followed up for 22 to 45 months(average, 32months). There were no significant differences with respect to JOA recovery rate and fusion rate between two groups(P >0.05). In group A: 1 patient had cage sink; in group B: 1 patient had donor site hematoma after operation, 2 patients suffered from dysphagia after operation and 2 patients suffered from donor site pain after one year; the complications showed significant difference between two groups(P <0.05). Conclusion The Solis cage leads to similar clinical outcomes compared to iliac bone graft with anterior plating for the treatment of the single level cervical spondylotic myelopathy, while Solis cage has lower complication rate and it’s simple to handle. However, Solis cage is not suitable for patients with severe osteoporosis.更多还原