中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (26): 4931-4935.doi: 10.3969/j.issn.1673-8225.2012.26.036

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

Smith-Robinson技术切除后纵韧带并金属植入物内固定治疗单节段 颈椎间盘突出症

孙 鹏，雪 原，王 沛，赵华健，李 鹏，李子龙   

  1. 天津医科大学总医院骨科，天津市 300052
  • 收稿日期:2011-09-29 修回日期:2011-11-08 出版日期:2012-06-24 发布日期:2013-11-02
  • 通讯作者: 雪原，博士，教授，硕士生导师，天津医科大学总医院，天津市 300052 xueyuanzyy@163.com
  • 作者简介:孙鹏★，男，1985年生，山东省济宁市人，汉族，天津医科大学在读硕士，主要从事脊柱外科与创伤研究。 sunpeng22055@163.com

Posterior longitudinal ligament resection by Smith-Robinson technique combined with metallic fixation for single-level cervical disc herniation

Sun Peng, Xue Yuan, Wang Pei, Zhao Hua-jian, Li Peng, Li Zi-long   

  1. Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin 300052, China
  • Received:2011-09-29 Revised:2011-11-08 Online:2012-06-24 Published:2013-11-02
  • Contact: Xue Yuan, Doctor, Professor, Master’s supervisor, Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin 300052, China xueyuanzyy@163.com
  • About author:Sun Peng★, Studying for master’s degree, Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin 300052, China sunpeng22055@163.com

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346

被引次数

1

摘要：

背景：Smith-Robinson技术结合金属植入物内固定已广泛用于治疗单节段颈椎间盘症，但是否切除后纵韧带仍有争议。
目的：观察Smith-Robinson技术切除后纵韧带并金属植入物内固定治疗单节段颈椎间盘突出症的疗效。
方法：回顾性分析2005/2008天津医科大学总医院骨科Smith-Robinson技术切除后纵韧带，使用Cage植骨融合、钛板螺钉置入内固定治疗的45例单节段颈椎间盘突出患者的临床资料。
结果与结论：治疗后随访12~36个月，随访12个月时JOA评分较治疗前明显提高(P < 0.05)，目测类比疼痛评分较治疗前明显降低(P < 0.05)，Cobb角、椎间隙高度较治疗前明显改善(P > 0.05)，最终融合率100%，未出现Cage移位。疗效评价，30例优，13例良，2例可，无症状加重者，末次随访优良率95.6%。说明通过Smith-Robinson技术切除后纵韧带即能够实现对脊髓、神经根的彻底减压，又能有效防止椎间隙坍陷、成角畸形等并发症。

关键词: 单节段, Cage植骨, 螺钉, 终板, Smith-Robinson, 后纵韧带, 颈椎间盘突出症, 植入体

Abstract:

BACKGROUND: Smith-Robinson technique combined with metallic fixation is widely used for the treatment of prolapse of single-level cervical intervertebral disc, but it is controversial to resect the posterior longitudinal ligament (PLL).
OBJECTIVE: To observe the effects of resection of PLL by Smith-Robinson technique combined with metallic fixation for treating prolapse of single-level cervical intervertebral disc.
METHODS: A total of 45 patients who underwent the PLL resection by the Smith-Robinson technique combined with bone grafting with peek Cage and titanium plate internal fixation for treating prolapse of single-level cervical intervertebral disc at the Department of Orthopedics, General Hospital of Tianjin Medical University between 2005 and 2008 were retrospectively analyzed.
RESULTS AND CONLUSION: All patients received a 12-36 months follow-up. Compared with preoperation, the mean JOA score was significantly increased (P < 0.05) and the visual analogue scale score was significantly decreased at a 12 months follow-up (P < 0.05). The segmental Cobb angle and disc height were significantly improved postoperatively (P < 0.05). At the last follow up a solid fusion was achieved in 100% and no graft displacement was noted. Excellent clinical results of 30 cases, good in 13 cases, 2 cases in fair, and poor in 0 case, the fine rate was 95.6%. It suggested that PLL resection by Smith-Robinson technique not only achieved the maximum pressure to the spinal cord and nerve root but also prevented the subsidence of the graft and angulation of the fused segment effect.

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