Xia Lei, Wang Yi-sheng, Zhai Fu-ying, Li Jun-wei
Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Wai Ke Za Zhi. 2006 Dec 15;44(24):1660-2.
To assess the clinical outcome of anterior fusion for unstable lower cervical spine.
From October 2000 to October 2004, anterior fusion were performed for 67 cases with unstable lower cervical spine with corresponding clinical manifestations. There were 38 males and 29 females with an average age of 33 years. Instability of lower cervical spine was radiographically determined by sagittal plane displacement between 2 cervical vertebrae of more than 3.5 mm or relative sagittal plane angulation greater than 11 degrees on maximal lateral flexion and extension films. Anterior interbody fusion methods included bone grafting with plate fixation or cage. JOA rating system was used for spine cord function assessment.
All patients were followed up for an average period of 14 months. Solid fusion was achieved for all operated levels. The majority of the patients got a satisfactory relief of preoperative symptoms. JOA scores for cord function improved from preoperative 10.15 to postoperative 14.95 with statistical difference (P < 0.05). Complications included screws loosing and backout in 2 cases. Revision surgery were performed with uneventful recovery.
Satisfactory clinical outcome can be achieved by proper selection of anterior fusion methods for patients with unstable lower cervical spine.
评估前路融合术治疗下颈椎不稳的临床疗效。
2000年10月至2004年10月，对67例有相应临床表现的下颈椎不稳患者施行前路融合术。其中男性38例，女性29例，平均年龄33岁。通过最大侧屈和伸展位X线片上两个颈椎椎体间矢状面移位大于3.5 mm或相对矢状面成角大于11度，影像学确定下颈椎不稳。前路椎间融合方法包括植骨加钢板固定或椎间融合器。采用JOA评分系统评估脊髓功能。
所有患者平均随访14个月。所有手术节段均实现了牢固融合。大多数患者术前症状得到满意缓解。脊髓功能JOA评分从术前的10.15提高到术后的14.95，差异有统计学意义（P < 0.05）。并发症包括2例螺钉松动和退出。行翻修手术，恢复顺利。
对于下颈椎不稳患者，适当选择前路融合方法可取得满意的临床疗效。
