【摘要】 目的:分析4种颈椎前路融合术的疗效。方法:用4种融合方式对241例颈椎病患者行前路减压。其中单纯髂骨植骨(A)组单节段40例,双节段22例;颈椎前路减压界面固定术(cervical interbody fusion cage,CIFC)(B)组单节段40例,双节段21例;植骨融合并颈椎前路钢板内固定(C)组单节段45例,双节段23例;CIFC并前路钢板内固定(D)组单节段35例,双节段15例。术后定期随访及拍摄X线片,观察疗效、椎间高度、颈椎前弯曲度和融合情况。结果:平均随访时间3.2年,A组融合率为82.1%,B组融合率为96.3%,C组融合率为95.6%,D组融合率为95.4%。终访时,A组平均椎间高度和颈椎前弯曲度较术后早期显著性降低(P<0.05),B组、C组和D组则无显著性差异(P>0.05)。A组与B、C组和D组之间远期疗效均有显著性差异(P<0.05),B组与C组和D组之间远期疗效无显著性差异(P>0.05)。结论:单纯髂骨植骨方法简单,但并发症较多。CIFC、颈椎前路钢板植骨融合内固定和CIFC并前路钢板内固定,固定牢固,符合颈椎生物力学特性,并发症少,远期疗效好。更多还原

【Abstract】 Objective: To compare therapeutic effects of four Anterior operation methods for Cervical Spondylosis.Methods:Two hundred and forty one patients with Cervical Spondylosis underwent the anterior decompression in four C-spine fusion methods,according to which they were divided into four groups:group A(pure autogenous iliac bone grafting with 40 cases,one-segment group and with 22 cases,two-segment group),group B(cervical interbody fusion cage,CIFC with 40 cases,one-segment group and with 21 cases,two-segment group),group C(autogenous iliac bone grafting plus anterior cervical plate-screw fixation with 45 cases,one-segment group and with 23 cases,two-segment group),group D(CIFC plus anterior cervical plate-screw fixation with 35 cases,one-segment group and with 15 cases,two-segment group).X-ray films were taken after operation to observe the interbody height,interbody angles and fusion rate of operative segment.Results:The average period of following-up was 3.2 years,fusion rate of groups A,B,C and D were 82.1%,96.3%,95.6% and 95.4% respectively.When the following-up was over,the average of interbody height and interbody angles had significantly reduced compared with early following-up in group A(P<0.05).There was no significant difference and complication of implanted material in group B,C and D.There was significantly long-term therapeutical effect difference between group A and groups B,C,D.but there was no significant difference among group A,group B and group C.Conclusion:The pure autogenous iliac bone grafting is simple but has more complications.CIFC,autogenous iliac bone grafting plus anterior cervical plate-screw fixation and CIFC plus anterior cervical plate-screw fixation can improve the stability,and have a good biomechanical character and its application has shown good prospects with fewer complications.更多还原