【摘要】：目的：分析經(jīng)頸前路椎體次全切除術(shù)(ACCF)治療的脊髓型頸椎病術(shù)后鈦籠下沉的相關(guān)影響因素。方法：回顧我科于2011年1月至2013年4月收治的,86例行頸椎前路椎體次全切除減壓+鈦籠植骨融合+鈦板內(nèi)固定術(shù)患者的資料,取術(shù)后隨訪6個(gè)月時(shí)的影像學(xué)資料,根據(jù)頸椎側(cè)位片顯示鈦籠下沉與否,分下沉組和非下沉組進(jìn)行觀察,分析術(shù)后鈦籠下沉與年齡、性別、BMI值、手術(shù)節(jié)段、臨床療效、病變節(jié)段撐開(kāi)角度和安置位置的關(guān)系。結(jié)果：①單因素分析結(jié)果：年齡、性別、BMI值、手術(shù)節(jié)段(C5-C7)這幾個(gè)方面的比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),其余差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組術(shù)后JOA評(píng)分均較術(shù)前明顯改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05),兩組間比較存在顯著統(tǒng)計(jì)學(xué)差異(P0.01)。兩組融合率比較無(wú)明顯統(tǒng)計(jì)學(xué)差異(P0.05)。撐開(kāi)角度30°者共63例,下沉組12例(19.0%),撐開(kāi)角度≥30°者共23例,下沉組10例(43.5%)。撐開(kāi)角度30°與撐開(kāi)角度≥30°對(duì)于下沉發(fā)生率的影響比較有統(tǒng)計(jì)學(xué)差異(P0.05)。椎體前緣與鈦籠前緣間距l(xiāng)mm者共66例,下沉組13例(19.7%),椎體前緣與鈦籠前緣間距≥1mm者共20例,下沉9例(45.0%),間距≥1mm與間距1mm對(duì)術(shù)后鈦籠下沉發(fā)生率的影響,其差異有統(tǒng)計(jì)學(xué)意義(P0.05)。②多因素分析結(jié)果顯示：撐開(kāi)角度(OR=6.236,P=0.005)和安置位置(OR=4.583,P=0.024)可能是ACCF術(shù)后鈦籠下沉的危險(xiǎn)因素。結(jié)論：撐開(kāi)角度和安置位置可能是影響術(shù)后引起鈦籠下沉的重要因素,此外年齡、性別、手術(shù)節(jié)段(C5-C7)、BMI對(duì)鈦籠下沉均有不同程度的影響。
[Abstract]:Objective: to analyze the related factors of titanium cage sinking in cervical Spondylotic myelopathy treated by subtotal cervical vertebra resection (ACCF) via anterior cervical approach. Methods: from January 2011 to April 2013, 86 patients with anterior subtotal cervical vertebra resection, decompression, titanium cage, bone fusion and titanium plate fixation were retrospectively reviewed. The imaging data of the patients who were followed up for 6 months after operation were analyzed. According to the lateral radiographs of cervical vertebrae, titanium cage sinking was observed, and the relationship between titanium cage subsidence and age, sex, BMI value, operative segment, clinical effect, the angle of extension of lesion segment and placement position was analyzed. Results: 1 the results of univariate analysis: age, sex, BMI value, operative segment (C5-C7), the differences were statistically significant (P0.05), the other differences were not statistically significant (P0.05). The postoperative JOA scores of the two groups were significantly improved compared with the preoperative, the difference was statistically significant (P0.05), there was a significant difference between the two groups (P0.01). There was no significant difference in fusion rate between the two groups (P0.05). There were 63 cases of distraction angle 30 擄, 12 cases (19.0%) of sinking group, 23 cases of distraction angle 鈮，

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