Objective To explore primarily the cause of titanium cage subsidence following cervical fusion. Method 56 patients with underwent anterior cervical decompression and fusion (ACDF) from June 2005 to June 2009. Al1 patients were followed up at 1 years following surgery including cervical plain film and clinical symptom. The diagnosis of titanium cage subsidence was made according to plain film and the possible cause was analyzed. Results Titanium cage subsidence was found in 12 patients. Incidence of subsidence in the cervical trauma was higher significantly than that of the CSM(P＜0.05). Neck collar helped to decrease the incidence of subsidence(P＜0.05). Patients with an intervertebral distracting angle over 30°was liable to subside than the angle less than 20° . Conculsion Titanium cage subsidence was a result of multiple biomerchanizm factors. Moderate intervertebral distracting force during operation and early neck collar post operation were necessary to prevent subsidence.%目的 探讨颈椎前路融合术后钛笼下沉的因素.方法 2005年6月至2009年6月56例患者在我科行ACDF手术,包括颈椎外伤14例,脊髓型颈椎病42例,手术方式均为C5椎体次全切钛笼植骨融合术.回顾性分析56例患者的颈椎平片和手术资料,研究影响钛笼下沉的因素.结果 56例手术患者中,术后1年复查时植骨全部融合,12例(21.4%)钛笼下沉.14例颈椎外伤患者中4例发生下沉,发生率为28.6%,而42例脊髓型颈椎病患者发生率为19.0%差异有显著性(P<0.05).术后佩戴颈托6～8周的25例患者,4例发生下沉,而佩戴颈托少于4周的患者中有8例发生下沉,两者发生率有显著差异(P<0.05).测9椎间撑开角,其中角度在10°-20°者46例,成角大于30°者10例,两组发生下沉例数分别为8例和4例,发生率有a著差异(P<0.05).结论 颈椎钛笼下沉是多种生物力学因素共同作用的结果,术中应避免椎间过度撑开,术后早期严格佩戴颈托.
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