【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會（Japan Orthopaedic Assoctiation， JOA）評分改善率評價患者神經功能恢復情況，復查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。 結果 14例患者均成功完成頸椎前路減壓手術以及椎間融合器的安放固定。所有患者術前癥狀均得到不同程度的改善，術后3、6、12個月的JOA改善率分別為87.0%、94.0%、97.0%。影像學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。 結論 n-HA/PA66頸椎間融合器具有早期支撐穩定功能，可有效維持頸椎椎間高度；術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.
