Zhao Bo, Qiu Xiaowen, Wang Dong, Li Haopeng, He Xijing
The Second Affiliated Hospital of Xi'an Jiaotong University, Department of Orthopedics, Xi'an/Shaanxi Province, PR China.
Clinics (Sao Paulo). 2016 Jul;71(6):320-4. doi: 10.6061/clinics/2016(06)06.
To examine the application of bioabsorbable screws for anterior cervical decompression and bone grafting fixation and to study their clinical effects in the treatment of cervical spondylosis.
From March 2007 to September 2012, 56 patients, 36 males and 20 females (38-79 years old, average 58.3±9.47 years), underwent a novel operation. Grafts were fixed by bioabsorbable screws (PLLA, 2.7 mm in diameter) after anterior decompression. The bioabsorbable screws were inserted from the midline of the graft bone to the bone surface of the upper and lower vertebrae at 45 degree angles. Patients were evaluated post-operatively to observe the improvement of symptoms and evaluate the fusion of the bone. The Japanese Orthopaedic Association (JOA) score was used to evaluate the recovery of neurological functions.
All screws were successfully inserted, with no broken screws. The rate of symptom improvement was 87.5%. All of the grafts fused well with no extrusion. The average time for graft fusion was 3.8±0.55 months (range 3-5 months). Three-dimensional reconstruction of CT scans demonstrated that the grafts fused with adjacent vertebrae well and that the screws were absorbed as predicted. The MRI findings showed that the cerebrospinal fluid was unobstructed. No obvious complications appeared in any of the follow-up evaluations.
Cervical spondylosis with one- or two-level involvement can be effectively treated by anterior decompression and bone grafting with bioabsorbable screw fixation. This operative method is safe and can avoid the complications induced by metal implants.
探讨可吸收螺钉在前路颈椎减压植骨固定中的应用，并研究其治疗颈椎病的临床效果。
2007年3月至2012年9月，56例患者（男36例，女20例，年龄38 - 79岁，平均58.3±9.47岁）接受了一项新手术。前路减压后采用可吸收螺钉（聚左旋乳酸，直径2.7 mm）固定植骨。可吸收螺钉从植骨块中线以45度角插入上下椎体骨面。术后对患者进行评估，观察症状改善情况并评估骨融合情况。采用日本骨科学会（JOA）评分评估神经功能恢复情况。
所有螺钉均成功植入，无螺钉断裂。症状改善率为87.5%。所有植骨融合良好，无移位。植骨平均融合时间为3.8±0.55个月（范围3 - 5个月）。CT扫描三维重建显示植骨与相邻椎体融合良好，螺钉按预期吸收。MRI检查结果显示脑脊液通畅。随访评估中均未出现明显并发症。
一或两个节段受累的颈椎病采用前路减压、可吸收螺钉固定植骨可有效治疗。该手术方法安全，可避免金属植入物引起的并发症。
