【摘要】 目的研究椎间融合器作为植入物在下颈椎骨折脱位行颈椎前路手术后的早期稳定性。方法统计本院自2010年1月至2018年1月收治的14例下颈椎骨折脱位行单纯颈椎前路手术患者,均采用椎间融合器联合锁定钛板固定重建颈椎稳定性,术后随访3～6个月,对比术前术后颈髓损伤神经功能评分、术前术后植骨愈合后颈椎在冠状位(Cobb角)、矢状位(颈椎前凸角、椎体后缘移位情况)及水平位(椎体高度)的稳定性。结果术后神经功能评分优于术前,术后颈椎在冠状位稳定性略有改善,差异无统计学意义(P>0.05),在矢状位及水平位稳定性明显提高,且差异具有统计学意义(P<0.05)。在植骨愈合前后,颈椎在冠状位及水平位稳定性稍差,差异无统计学意义(P>0.05)。在矢状位稳定性稍改善,且差异具有统计学意义(P<0.05)。结论椎体稳定性研究需从椎体矢状位、水平位及冠状位3个方向着眼。颈椎压缩性骨折或撕脱性骨折伴脱位患者可行椎间盘切除椎间融合器联合锁定钛板固定。椎间融合器在术后早期恢复中存在椎体下沉及矢状位移位问题,需引起重视。更多还原

【Abstract】 Objective To study the stability of intervertebral fusion cage as implants in the early stage after anterior cervical surgery for lower cervical spine fracture and dislocation. Methods A total of 14 patients with fracture and dislocation of lower cervical spine were enrolled in our hospital from January 2010 to January 2018, who underwent simple anterior cervical surgery with intervertebral fusion cage combined with locking titanium plate. All patients were followed up for3 to 6 months. The neurofunction scores of cervical spinal before and after operation were compared. The stability of cervical spine in coronal position(Cobb angle), in sagittal position(cervical lordosis angle, displacement of posterior edge of vertebral body) and in horizontal position(vertebral height) were collected. Results Postoperative neurofunction score was better than before. The stability of cervical spine in coronal position was slightly improved after operation,with no significant difference(P>0.05). The stability in sagittal and horizontal position was significantly improved with significant difference(P<0.05). The stability of cervical spine in coronal and horizontal position was slightly worse after healing of bone graft, with no significance difference(P>0.05). In sagittal position it was slightly improved with significant difference(P<0.05). Conclusion The stability of spine should be considered in three directions: sagittal, horizontal and coronal. The patients with compression fracture or avulsion fracture combined with dislocation of cervical spine can be treated by intervertebral fusion cage and locking titanium plate. There was the problem of vertebral subsidence and displacement of vertebral body in sagittal of the intervertebral fusion cage in the early recovery, which needs to be paid attention to.更多还原