CT重建评价颈椎螺纹融合器植骨融合的可行性研究
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摘要
目的:探索利用CT重建评价颈椎螺纹融合器植骨融合的可行性。方法:随访因颈椎病行颈椎螺纹融合器+钛板植入术后患者51例,随访时间6～15个月,其中男32例,女19例,平均年龄(45.4±2.4)岁,于术后7天摄颈椎正侧位X线片,随访时摄颈椎过曲过伸位和正侧位X线片,并行颈椎CT重建,分别采用X线法和CT重建法评价植骨融合情况,CT法分优、良、差三级。结果:X线法观察植骨融合率为100%,CT重建法观察植骨融合率为94.1%,两种方法经统计学分析无显著差异(P>0.05)。结论:在对植骨融合进行评估时,和X线相比,CT重建法更加准确和直观,能对植骨融合生长情况进行了解,值得临床推广。
Objective: To evaluate the bone graft fusion in the cervical threaded cage and search for a better assessment method. Methods: To follow up 51 patients having undergone the cervical threaded cage plus internal fixed plate system for 6 to 15 months, average age of 45 years, 32 male, 19 female. To take the anterior and posterior, lateral plain radiographs within 1 week post operation, and to take the both positions plain radiographs above plus flexion and extension dynamic plain radiographs when followed up, also with the CT reconstructions of the cervical vertebra, by which the condition of bone fusion could be classified as excellent, good and poor three grades, then we will analyze the result by both methods. Results: The rate of the bone graft fusion was 100% by plain radiograph and 94.1% by CT reconstruction. No statistical significant difference was found between the two methods. Conclusion: The CT reconstruction method seems more visualized, accurate, and objective than plain radiograph in evaluating the bone fusion of the cervical cage and could observe the specialized way of the bone graft growth, find the poor growth with no internal fixed system displacement yet hardly be found by plain radiograph.
Objective: To evaluate the bone graft fusion in the cervical threaded cage and search for a better assessment method. Methods: To follow up 51 patients having undergone the cervical threaded cage plus internal fixed plate system for 6 to 15 months, average age of 45 years, 32 male, 19 female. To take the anterior and posterior, lateral plain radiographs within 1 week post operation, and to take the both positions plain radiographs above plus flexion and extension dynamic plain radiographs when followed up, also with the CT reconstructions of the cervical vertebra, by which the condition of bone fusion could be classified as excellent, good and poor three grades, then we will analyze the result by both methods. Results: The rate of the bone graft fusion was 100% by plain radiograph and 94.1% by CT reconstruction. No statistical significant difference was found between the two methods. Conclusion: The CT reconstruction method seems more visualized, accurate, and objective than plain radiograph in evaluating the bone fusion of the cervical cage and could observe the specialized way of the bone graft growth, find the poor growth with no internal fixed system displacement yet hardly be found by plain radiograph.
引文
[1]梁定顺,倪斌.颈椎椎间融合器的临床应用进展[J].中国矫形外科杂志,2006,14(3):384-386.
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[2]Samandouras G,Shafafy M,Hamlyn PJ.A new anterior cervical instrumentation system combining an intradiseal cage with an integrated plate:an early technical report[J].Spine,2001,26(10):1188-1192.
[3]Hacker RJ.Threaded cages for degenerative cervical disease[J].Clin Orthop,2002,394(12):473-480.
[4]钱邦宗,唐天驷.颈椎前路减压融合术现状与展望[J].国外医学,骨科学分册2002,23(2):72-74.
[5]Rajesh R,Saeed Mohammed,A Saifuddin,et al.Comparision of plain radiographs with CTscan to evaluate interbody fusion following the use of Titanium interbody cages and transpedicular instrumention[J].Eur spine J,2003,12(6):378-385.
[6]Yuan,H,Kuslich S,Dowdle J,et al.Prospective multicenter clinical trial of the BAK interbody cage system[C].The Annual Meeting of the North American Spine Society,New York,1997.
[7]Frank Kandzioda.Treatment of traumatic cervical spine instability with interbody fusion cages:A prospective controlled study with a2-year follow-up[J].Injury Int.J.Care Injured,2005,36(12).
[8]Matage G.cervical cage fusion with 5different implants 250 cases[J].Acta Neurochir(Wien),2002,144(6):539-550.
[9]Majd ME,Vadhva M,Holt RT.Anterior cervical reconstruction using titanium cages with anterior plating SpineSurgery[J].Spine,1999,24(15):1604-10.
[10]McAfee P,Regan J,Farey I,et al.The biomechanical and histomorphometric properties of anterior lumbar fusions:a canine model[J].Spinal Disord,1988,22(1):105.