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前路颈椎间盘切除、融合及钢板螺钉内固定术——早期经验

Anterior cervical discectomy, fusion and stabilization by plate and screw--early experience.

作者信息

Islam M A, Islam M A, Habib M A, Sakeb N

机构信息

Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka.

出版信息

Bangladesh Med Res Counc Bull. 2012 Aug;38(2):62-6. doi: 10.3329/bmrcb.v38i2.12884.

Abstract

Anterior cervical plating is commonly performed to stabilize anterior cervical fusion. The aim of the study was to evaluate the clinical and functional outcome, radiological fusion and operative complications in cases of cervical spondylotic myelopathy and radiculopathy who underwent Anterior Cervical Discectomy and Fusion (ACDF) by autograft and stabilized with plate and screw. We evaluated 16 consecutive patients (M: F = 10:6) from January 2008 to December 2010 in Bangabandhu Sheikh Mujib Medical University (BSMMU) and different private hospitals in Dhaka, in cases where adequate conservative treatment failed. Single level ACDF by autograft and stabilization by plate and screw was done in 10 patients and 06 patients had two levels fusion. The mean follow up period was 18 months. The patients improved significantly (p < 0.05) and the recovery rate was 87.50%. All patients showed radiological fusion (p < 0.001). There was no hardware failure, graft extrusion or plate breakage. ACDF with plate and screw is fairly safe and effective therapy for cervical disc degeneration leading to myelo-radiculopathy where major post operative complications are uncommon.

摘要

颈椎前路钢板固定术常用于稳定颈椎前路融合。本研究的目的是评估接受自体骨移植并使用钢板螺钉固定的颈椎前路椎间盘切除融合术(ACDF)治疗脊髓型颈椎病和神经根型颈椎病患者的临床和功能结果、影像学融合情况及手术并发症。2008年1月至2010年12月期间,我们在孟加拉国国父谢赫·穆吉布医学大学(BSMMU)和达卡的不同私立医院,对16例连续患者(男:女 = 10:6)进行了评估,这些患者均是在充分保守治疗失败的情况下接受治疗。10例患者接受了单节段自体骨移植ACDF并使用钢板螺钉固定,6例患者进行了双节段融合。平均随访期为18个月。患者有显著改善(p < 0.05),恢复率为87.50%。所有患者均显示影像学融合(p < 0.001)。未出现内固定失败、植骨块脱出或钢板断裂情况。对于导致脊髓神经根病的颈椎间盘退变,使用钢板螺钉的ACDF是一种相当安全有效的治疗方法,术后主要并发症并不常见。

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