【摘要】 目的 探討納米羥基磷灰石/聚酰胺66（nano-hydroxyapatite polyamide66，n-HA/PA66）頸椎融合器在頸椎間盤突出癥前路手術(shù)重建中的臨床療效。 方法 2008年12月-2010年6月，對14例頸椎間盤突出癥患者行前路椎間盤切除、椎管減壓，以n-HA/PA66椎間融合器支撐植骨、鋼板螺釘內(nèi)固定治療。隨訪時間3～12個月，平均6.3個月；隨訪時以日本矯形外科學(xué)會（Japan Orthopaedic Assoctiation， JOA）評分改善率評價患者神經(jīng)功能恢復(fù)情況，復(fù)查X線片評估椎間融合器植骨融合情況，包括椎間高度及椎間融合器下沉情況。 結(jié)果 14例患者均成功完成頸椎前路減壓手術(shù)以及椎間融合器的安放固定。所有患者術(shù)前癥狀均得到不同程度的改善，術(shù)后3、6、12個月的JOA改善率分別為87.0%、94.0%、97.0%。影像學(xué)檢查顯示所有患者植骨融合，椎間高度及椎間融合器的位置維持良好，無下沉、移位。 結(jié)論 n-HA/PA66頸椎間融合器具有早期支撐穩(wěn)定功能，可有效維持頸椎椎間高度；術(shù)后植骨融合率高且便于X線片觀察，是頸椎間盤突出癥患者前路手術(shù)植骨的理想支撐材料，但長期效果需進一步隨訪觀察。
【Abstract】 Objective To evaluate the clinical effect of artificial cervical vertebra fusion apparatus of n-HA/PA66 in anterior reconstruction of cervical intervertebral disc herniation. Methods From December 2008 to June 2010, 14 patients with cervical intervertebral disc herniation underwent anterior cervical discectomy,spinal canal decompression,spinal canal decompression and reconstruction by n-HA/PA66 composite artificial vertebral body combined with plate instrumentation. The patients were followed up for 3 to 12 months with an average of 6.3 months. Neurological function was evaluated by improvement rate of JOA score and situations of the supporting body was observed by X-ray in 3,6,and 12 months after the surgery.The intervertebral height,the 1ocations, and the fusion rate of the supporting body were assessed in order to evaluate the stability of the cervical spine and alignment improvements. Results All the patients had undergone the operation successfully.The preoperative symptoms improved to varying degrees.JOA improvement rate were 87.0%, 94.0%, and 97.0% 3,6,and 12 months after the operation,respectively.Imaging studies showed that in all cases graft fusion were achieved,and cervical alignments,intervertebral height,cervical spine stability and the locations of the artificial vertebral body were well maintained.No displacement and subsidence of the artificial vertebral body occurred. Conclusion n-HA/PA66 artificial vertebral body can provide early cervical spine support and stability and cervical intervertebral height.It has a high rate of graft fusion and is convenient to observe by X-ray.Therefore,n-HA/PA66 can be taken as an ideal graft for anterior degenerative cervical spine operation,but further follow-up study is still needed to evaluate the long-term effects.
引用本文： 曾凡偉,王曉林,李俊. 羥基磷灰石/聚酰胺66頸椎融合器在頸椎間盤突出癥前路手術(shù)重建中的臨床療效. 華西醫(yī)學(xué), 2010, 25(11): 2032-2034. doi: 復(fù)制
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- 1. 姚本順, 謝遠軍. 中醫(yī)藥治療頸椎間盤突出癥的臨床研究進展[J]. 中國中醫(yī)骨傷科雜志, 2008, 16(10): 68-69.
- 2. Bohler J, Gandemak T. Anterior plate for stabilization fracture-dislocations of the lower cervical spine[J]. J Trauma, 1980, 20(3): 203-205.
- 3. Fujiwara A, Kobayashi N, Saiki K, et al. Association of the Japanese orthopaedic association score with the oswestry disability index, roland-morris disability questionnaire, and short form 36[J]. Spine, 2003, 28(14): 1601-1607.
- 4. 李鴻, 李玉寶, 嚴(yán)永剛, 等. 納米羥基磷灰石∕聚酰胺66多孔材料制備和生物安全性初步評價[J]. 生物醫(yī)學(xué)工程學(xué)雜志, 2008, 25(5): 1126-1129.
- 5. 孟純陽, 安洪, 蔣電明, 等. 新型納米骨重建和修復(fù)材料羥基磷灰石/聚酰胺體內(nèi)植入的生物相容性及安全性[J]. 中國臨床康復(fù), 2004, 29(8): 6330-6331.
- 6. 蔣電明, 權(quán)正學(xué), 歐云生, 等. 納米羥基磷灰石/聚酰胺66復(fù)合生物活性人工椎體在胸腰椎爆裂骨折中的應(yīng)用[J]. 中華創(chuàng)傷雜志, 2006, 22(12): 884-885.
- 7. Kanyama M, Hashimoto T, Shigenobu K, et al. Pitfall of anteriorcervical fusion using titanium mesh and local autograft[J]. J Spine Disord Tech, 2003, 16(6): 513-515.
- 8. 權(quán)正學(xué), 蔣電明, 歐云生, 等. n-HA/PA66復(fù)合生物活性人工椎體在頸椎前路椎間融合治療脊髓型頸椎病中的應(yīng)用[J]. 重慶醫(yī)學(xué), 2008, 37(15): 1687-1689.
- 9. 蔣電明, 權(quán)正學(xué), 歐云生, 等. n-HA/PA66復(fù)合生物活性支撐材料在重建椎體結(jié)構(gòu)中的初步臨床應(yīng)用[J]. 重慶醫(yī)學(xué), 2007, 36(11): 1010-1012.
- 10. 修鵬, 劉立岷, 宋躍明, 等. 納米羥基磷灰石/聚酰胺66椎體支撐體在脊髓型頸椎病前路手術(shù)重建中的應(yīng)用[J]. 中國骨與關(guān)節(jié)外科, 2009, 2(5): 347-351.