CAJ | 학술논문

背景：随着前路钛板的广泛应用，术后一些并发症如吞咽困难、钛板松动、螺钉退出及邻近阶段椎间盘退变等越来越引起研究者的关注，而桥形固定颈椎前路融合器系统的应用有望避免这些并发症。 　　目的：观察桥形固定颈椎前路融合器ROI-C在颈椎前路手术中应用的初步疗效。 　　方法：2013年4至12月，苏州大学附属无锡九院应用ROI-C进行前路减压融合内固定治疗颈椎病患者32例，融合器中均植入骨诱导促进椎间融合。32例中脊髓型颈椎病23例，神经根型颈椎病2例，颈髓过伸伤3例，颈椎间盘突出1例，颈椎不稳2例，节段性颈椎后纵韧带骨化1例。内固定前及末次随访时测定JOA及NDI评分评价神经症状及功能改善情况，同时记录不良反应。 　　结果与结论：32例患者均完成了4-8个月的门诊定期随访，所有患者的临床症状、脊髓功能明显改善，未出现ROI-C松动移位及二次手术。椎间融合平均时间4.2个月(3-5个月)；JOA评分由内固定前平均9.2分上升至术后13.8分，末次随访时JOA评分、NDI评分均较内固定前提高(P<0.05)。提示ROI-C在颈椎前路手术中能有效地恢复病变椎间隙高度，能获得颈椎稳定性重建及椎体间融合，有效避免因植入钢板固定而引起的相关手术并发症，改善神经症状及功能，近期效果良好。
배경：수착전로태판적엄범응용，술후일사병발증여탄인곤난、태판송동、라정퇴출급린근계단추간반퇴변등월래월인기연구자적관주，이교형고정경추전로융합기계통적응용유망피면저사병발증。 　　목적：관찰교형고정경추전로융합기ROI-C재경추전로수술중응용적초보료효。 　　방법：2013년4지12월，소주대학부속무석구원응용ROI-C진행전로감압융합내고정치료경추병환자32례，융합기중균식입골유도촉진추간융합。32례중척수형경추병23례，신경근형경추병2례，경수과신상3례，경추간반돌출1례，경추불은2례，절단성경추후종인대골화1례。내고정전급말차수방시측정JOA급NDI평분평개신경증상급공능개선정황，동시기록불량반응。 　　결과여결론：32례환자균완성료4-8개월적문진정기수방，소유환자적림상증상、척수공능명현개선，미출현ROI-C송동이위급이차수술。추간융합평균시간4.2개월(3-5개월)；JOA평분유내고정전평균9.2분상승지술후13.8분，말차수방시JOA평분、NDI평분균교내고정전제고(P<0.05)。제시ROI-C재경추전로수술중능유효지회복병변추간극고도，능획득경추은정성중건급추체간융합，유효피면인식입강판고정이인기적상관수술병발증，개선신경증상급공능，근기효과량호。
BACKGROUND:With the extensive application of anterior titanium plate, postoperative complications such as dysphagia, titanium loose, screw exit and disc degeneration of neighboring segments induced more and more attention of researchers. However, the application of anterior cervical cage is expected to avoid these complications. OBJECTIVE:To observe primary curative effect of anterior cervical cage ROI-C in anterior cervical spine surgery. METHODS:A total of 32 patients with cervical spondylosis were treated with anterior cervical cage ROI-C in the Wuxi Ninth Hospital Affiliated to Soochow University from April to December 2013. The cage was implanted to promote interbody fusion. Of 32 cases, 23 cases affected cervical spondylotic myelopathy, 2 cases affected nerve root type cervical spondylosis, 3 cases affected cervical hyperextension injury, 1 case affected cervical disc herniation, 2 cases affected cervical instability and 1 case affected segmental cervical ossification of the posterior longitudinal ligament. Japanese Orthopaedic Association and NDI scores were determined to assess neurological symptoms and functional improvement before internal fixation and during final fol ow-up. Simultaneously, adverse reactions were recorded. RESULTS AND CONCLUSION:A total of 32 patients finished the regular fol ow-up for 4 to 8 months. Clinical symptoms and spinal cord function of al patients were obviously improved. No ROI-C loosing or displacement or secondary surgery was found. The average fusion time was 4.2 months (3 to 5 months). Mean score of Japanese Orthopaedic Association was increased from 9.2 points pre-surgery to 13.8 points post-surgery. Japanese Orthopaedic Association and NDI scores were higher during final fol ow-up than before fixation (P<0.05). These data indicated that ROI-C effectively restored intervertebral height in anterior cervical spine surgery, stably reconstructed cervical vertebra, obtained interbody fusion, effectively avoided related surgical complications induced by plate implantation, improved neurological symptoms and function, and showed good short-term effects.