CAJ | 학술논문

目的比较钛网融合器与新型纳米羟基磷灰石/聚酰胺66(n-HA/PA66)复合生物活性人工椎体在重建颈椎稳定性时的临床疗效.方法选取25例脊髓型颈椎病患者采用颈前路钛网植骨融合、钛板内固定术治疗(A组),12例各类颈椎疾病患者采用n-HA/PA66复合生物活性人工椎体植骨融合、钛板内固定术治疗(B组).比较两种椎体替代物重建颈椎稳定性时的疗效.观察患者椎间隙高度的变化和植骨融合情况,并采用日本矫形外科协会(JOA)评分评价神经功能的变化.结果随访6～20(15.4±4.2)个月.两组患者末次随访时植骨均已融合.术前JOA评分:A组(8.40±0.96)分,B组(8.33±1.07)分,两组比较差异无统计学意义(P＞0.05);术后JOA评分:A组(14.36±0.86)分,B组(14.83±0.71)分,两组比较差异无统计学意义(P＞0.05),但两组各自术前、术后JOA评分比较差异有统计学意义(P＜0.05).两组优良率均为100%.A组有6例出现钛网下沉,B组有1例出现人工椎体下沉,但均无明显的临床症状.结论钛网融合器与n-HA/PA66复合生物活性人工椎体均有下沉的可能,且钛网融合器下沉率较n-HA/PA66复合生物活性人工椎体高,但两种椎体替代物均能有效重建颈椎的稳定性,获得良好的融合率,改善脊髓功能.
목적 비교태망융합기여신형납미간기린회석/취선알66(n-HA/PA66)복합생물활성인공추체재중건경추은정성시적림상료효.방법 선취25례척수형경추병환자채용경전로태망식골융합、태판내고정술치료(A조),12례각류경추질병환자채용n-HA/PA66복합생물활성인공추체식골융합、태판내고정술치료(B조).비교량충추체체대물중건경추은정성시적료효.관찰환자추간극고도적변화화식골융합정황,병채용일본교형외과협회(JOA)평분평개신경공능적변화.결과 수방6～20(15.4±4.2)개월.량조환자말차수방시식골균이융합.술전JOA평분:A조(8.40±0.96)분,B조(8.33±1.07)분,량조비교차이무통계학의의(P＞0.05);술후JOA평분:A조(14.36±0.86)분,B조(14.83±0.71)분,량조비교차이무통계학의의(P＞0.05),단량조각자술전、술후JOA평분비교차이유통계학의의(P＜0.05).량조우량솔균위100%.A조유6례출현태망하침,B조유1례출현인공추체하침,단균무명현적림상증상.결론 태망융합기여n-HA/PA66복합생물활성인공추체균유하침적가능,차태망융합기하침솔교n-HA/PA66복합생물활성인공추체고,단량충추체체대물균능유효중건경추적은정성,획득량호적융합솔,개선척수공능.
Objective To compare the clinical outcomes of cervical vertebral reconstruction using titanium mesh and nano-hydroxyapatite and polyamide 66 (n-HA/PA66) mesh as two different kinds of artificial vertebrae. Methods From January 2008 to June 2009 had surgically treated 37 cases of cervical spondylosis with anterior corpectomy for decompression, and artificial vertebrae implanted combined platescrews fixation for cervical reconstruction and fusion. As a vertebral substitution, titanium mesh were implanted in 25 cases ( group A ), and the others (12 cases, group B) were implanted with n-HA/PA66 mesh. The height of fusion space immediately postoperatively and the implanted condition were observed. The fusion rate and the JOA score were recorded to compare the clinical outcomes. Results Two groups received 6-20 ( 15.4 ±4.2 )months follow-up. When follow-up to the end grafts were already fusion. The preoperative JOA score in group A,B [(8.40 ±0.96) scores vs. (8.33 ±1.07) scores(P ＞ 0.05)] were increased to (14.36 ±0.86)scores and (14.83 ±0.71) scores after postoperatively (P＞ 0.05),but there were statistically significant differences between preoperative and postoperative each group (P＜0.05). There were 6 cases artificial vertebrae in group A and 1 case in group B subsided asymptomaticly with 100% choiceness rate. Conclusion These two kinds of artificial vertebrae could show similar outcomes in cervical vertebral reconstruction, but the n-HA/PA66 mesh has a lower subsidence rate.