Objective To discuss recent clinical effects of biodegradable fixed plate in anterior cervical decompression and fusion.Methods Thirty-three patients who treated cervical spondylotic myelopathy by Smith-Robinson intervertebral disc excision and bone graft fusion of biodegradable fixed plate from October 2012 to December 2013 were selected,including 16 male patients and 17 female patients,aged from 36 to 65 (51.5±6.2 on the average).28 cases were involved in single segment,and 5 cases were involved in double segment.Clinical outcomes were evaluated by modified Japanese Orthopaedic Association (mJOA) score,visual analogue scale (VAS) and Odom's criteria.Bone graft fusion was observed through X-ray film.Results Follow-up visit was conducted for all patients,with follow-up visit time of 7 to 20 months (12.1 months on the average).At the last follow-up visit,mJOA score (15.4± 1.2) increased compared with the pre-operation score (11.1± 1.5).The difference has statistical significance.VAS score (1.3±0.7) decreased compared with the pre-operation score (6.8± 1.1).The difference has statistical significance.26 cases had excellent Odom's criteria,5 cases had favorable Odom's criteria,2 cases had general Odom's criteria,with the excellence rate of 93.9％ (31/33).In the last follow-up visit,37 segments reached bone fusion,with the fusion rate of 97.4％ (37/38).Preoperative intervertebral space height and cervical vertebra sequence improved or maintained.There was no obvious local inflammatory response in the process of follow-up visit.Conclusion Recent clinical effects of biodegradable fixed plate in anterior cervical decompression and fusion are good.Such method can restore intervertebral space height and cervical vertebra sequence to some extent,improve patients' clinical symptoms and living quality,and gain high bone graft fusion rate.%目的 探讨采用可吸收固定板的颈椎前路减压融合术的近期临床疗效.方法 2012年10月至2013年12月,采用Smith-Robinson颈前入路椎间盘切除植骨融合可吸收板内固定术治疗脊髓型颈椎病33例,男16例,女17例;年龄36～65岁,平均(51.5±6.2)岁.单节段28例,双节段5例.手术节段:C3.45例,C456例,C5.611例,C6.76例,C3.4+C4.51例,C45+C563例,C5.6+C6.71例.评估术前及末次随访时改良日本骨科协会(Japanese Orthopaedic Association,JOA)评分、疼痛视觉模拟评分(visual analogue scale,VAS)、颈椎病患者术后日常活动能力Odom分级,摄X线片观察植骨融合情况.术前改良JOA评分7～13分,平均(11.1±1.5)分;术前疼痛VAS评分6～9分,平均(6.8±1.1)分.结果 所有患者均获得随访,随访时间7～20个月,平均12.1个月.末次随访时改良JOA评分(15.4±1.2)分,较术前增加,差异有统计学意义;疼痛VAS评分(1.3±0.7)分,较术前降低,差异有统计学意义.颈椎病患者术后日常活动能力Odom分级优26例、良5例、可2例,优良率93.9％(31/33).末次随访时37个节段达到骨性融合,融合率97.4％(37/38).术后椎间隙高度及颈椎序列均得到改善或维持,随访过程中无明显局部炎症反应.结论 颈前路椎间盘切除植骨融合可吸收板内固定术近期疗效优良,可在一定程度上恢复椎间隙高度及颈椎序列,改善患者临床症状及生活质量,获得较高的植骨融合率.
展开▼
