CAJ | 학술논문

目的探讨颈椎间融合器(SOLIS)治疗外伤性颈椎间盘突出症的临床疗效.方法 53例单纯外伤性单节段颈椎间盘突出症患者,随机分成三组(A组、B组、C组),均按相同的标准完成颈椎前路减压术,A组18例植入带自体松质骨的SOLIS,B组16例植入带自体松质骨的syTlcage,C组19例植骨加ACPS行颈椎融合.观察三组骨融合情况、稳定性和椎间隙高度变化,并以JOA评分评价神经功能恢复情况.结果全部患者均于术后3～9个月骨性融合;术后随访平均16.5个月,A组SOILS位置良好,病变椎间隙高度和颈椎生理曲度恢复正常并无丢失发生,术前后JOA评分分别为:(10.4±2.4)、(14.9±2.0)分(P<0.01);B组5例s),Syncage塌陷,椎间高度和颈椎生理曲度丢失,术前后JOA评分分别为:(10.6±2.5)、(13.2±2.3)分(P<0.05);C组18例ACPS位置良好,1例发生螺钉钛板滑脱,术前后JOA评分分别为:(10.5±2.4)、(15.1±19)分(P<0.01);手术后JOA评分A组和c组之间比较差异无统计学意义(P>0.05),A、C组同B组之间比较均有统计学意义(均P<0.05).结论 SOLIS用于单纯外伤性单节段颈椎间盘突出症的治疗融合率高,神经功能改善优良率高,椎间高度丢失低.
목적 탐토경추간융합기(SOLIS)치료외상성경추간반돌출증적림상료효.방법 53례단순외상성단절단경추간반돌출증환자,수궤분성삼조(A조、B조、C조),균안상동적표준완성경추전로감압술,A조18례식입대자체송질골적SOLIS,B조16례식입대자체송질골적syTlcage,C조19례식골가ACPS행경추융합.관찰삼조골융합정황、은정성화추간극고도변화,병이JOA평분평개신경공능회복정황.결과 전부환자균우술후3～9개월골성융합;술후수방평균16.5개월,A조SOILS위치량호,병변추간극고도화경추생리곡도회복정상병무주실발생,술전후JOA평분분별위:(10.4±2.4)、(14.9±2.0)분(P<0.01);B조5례s),Syncage탑함,추간고도화경추생리곡도주실,술전후JOA평분분별위:(10.6±2.5)、(13.2±2.3)분(P<0.05);C조18례ACPS위치량호,1례발생라정태판활탈,술전후JOA평분분별위:(10.5±2.4)、(15.1±19)분(P<0.01);수술후JOA평분A조화c조지간비교차이무통계학의의(P>0.05),A、C조동B조지간비교균유통계학의의(균P<0.05).결론 SOLIS용우단순외상성단절단경추간반돌출증적치료융합솔고,신경공능개선우량솔고,추간고도주실저.
Objective To evaluate the application of SOLIS in the surgery on anterior intervertebral fusion for the treatment of traumatic cervical disc protrnsion. Methods 53 traumatic single segment cervical disc protrusion were divided into three groups randomly. The A group (SOLIS) :n=18, SOLIS filled with autocancellous bone were implanted between the cervical vertebrae. The B group(Syncage) :n =16, as the first group Syncage filled with auto-cancellous bone were implanted. The C group:n=19,anterior cervical decompression and fusion with bone autograft and internal fixation with ACPS. The operations of the surgery on anterior cervical decompression in three groups were the same. Recovery of nerve function was observed by JOA score and the fusion state, stability and changes of interver-tebra height of fusion segment were evaluated by X ray. Results The average duration of the follow-up was 16.5 months in 53 cases. Bony fusion could be found 3～9months after operation in all cases. In all A (SOLIS) group cases,the movement of the implanted $OLIS Cage were not found. The heights of the cervical intervertebral spaces and the physiological curvature were restored without loss in the duration of follow-up. The average JOA was(10.4±2.4) be-fore operation and(14.9±2.0)after operation. There was highly significant variation between the former and the latter (P<0.01). In the B (Syncage)group,5 cases had cage subsidence, therefore the height of intervertebra and the phys-iological curvature were lost. The average JOA was (10.6±2.5) before operation and (13.2±2.3) after operation.There was significant variation between the former and the latter(P<0.05). In the C group the third group, the move-ment of the fixed titanium plate were not found in the duration of follow-up in 18 cases. The titanium plate fixation was loose in 1 case. The average JOA was(10.5±2.4) bofore operation and(15.1±1.9) after operation. There was high-ly significant variation between the former and the latter(P<0.01). After operation,there was significant difference in the JOA score between the A group and the B group,between the C group and the B group(P<0.05) ,and there was no difference between the A group and the C group(P>0.05). Conclusion Treatment of single segment prolapse of the cervical intervertebral disc with SOLIS cage has some advantages such as higher fusion rate, higher recovery rate of nerve function and low rate of loss of intervertebra] height.