摘要
目的探讨颈前路零切迹椎间融合内固定系统治疗脊髓型颈椎病的临床效果及安全性。方法选择2012年1月至2014年12月我院收治的脊髓型颈椎病患者63例,根据治疗方法不同分为两组,其中观察组采用颈前路零切迹椎间融合内固定系统治疗(37例),对照组采用颈前路减压植骨融合术联合钛板固定治疗(25例),比较两组患者手术时间、术中出血量、日本骨科协会(JOA)评分、椎间高度、颈椎Cobb角、椎间融合率及术后并发症情况。结果两组患者均成功完成手术,两组手术时间无显著性差异(P>0.05),但观察组术中出血量明显少于对照组(P<0.05)。术后3、9、18个月进行随访,两组患者JOA评分、椎间高度、颈椎Cobb角均明显高于术前水平(P<0.05),但在相同时间段两组患者JOA评分、椎间高度、颈椎Cobb角无明显差异(P>0.05)。随访末期两组患者椎间融合率均为100%,且未见钛板和螺钉松动、断裂等并发症,观察组出现1例轻度吞咽困难,经对症治疗后症状消失,对照组出现3例重度吞咽困难。结论颈前路零切迹椎间融合内固定系统与颈前路减压植骨融合术联合钛板固定治疗脊髓型颈椎病均能重建颈椎曲度并恢复椎间隙高度,但颈前路零切迹椎间融合内固定系统治疗较颈前路减压植骨融合术联合钛板固定能有效减少术中出血量及术后并发症发生率,安全性更高。
Objective To investigate the efficacy and safety of the zero-profile anterior cervical interbody fusion internal fixation system inthe treatment of cervical spondylotic myelopathy. Methods Sixty-three patients with cervical spondylotic myelofrom January 2012 to December 2014 were divided rnto two groups according to d i fferent treatment methods. The obwith the zero-profile anterior cervical rniterbody fusion and rniternal fixation system （37 cases） ; the control group was treated with anterior cervical decompression and bone gratt fusion n combination with titanium plates （25 cases）. The operation duration^ intraoperative blood loss, Japanese Orthopedic Association （JOA） score, intervertebral height,cervical Cobb angle, interbody fusion rate and postoperative complications were compared between the two groups. Results There was no significant di ference n the operation duratio0.05）,but the blood loss n the observation group was significantly lower than that n the control group （P〈0. 05）. The JOA score,intervertebral height and cervical Cobb angle were significantly higher at the 3,9 and 18 months postoperatively, compared with thepreoperative level （P〈0. 05）. But at the same follow-up tme points, there was no significant diference n the JOA scores, intervertebralheight or cervical Cobb angle （P〉0. 05）. At the end of follow-up, the intervertebral fusion rate was 100% in the two groups, and nocomplications such as loosening or breakage of the titanium plates or screws were noted. One case of mild dysphagia was observed n theobservation group,but symptoms disappeared after conservative treatment. In the control group, there were 3 cases of severe dysphagia.Conclusion Both the zero-profile anterior cervical interbody fusion and fixation system and the anterior cervical decompression and bone gratt.fusion combined with titanium plate fixation .for cervical spondylotic myelopathy can reconstruct cervical curvature and restore intervertebral space height stably and reliably, but the former is more effective and safer in the reduction of intraoperative blood loss and postoperativecomplications.
出处
《国际骨科学杂志》
2017年第3期192-196,共5页
International Journal of Orthopaedics
基金
新疆维吾尔自治区自然科学基金(2016D01C224)
关键词
脊髓型颈椎病
颈前路减压
零切迹椎间融合内固定系统
Cervical spondyloticmyelopathy
Anterior cervical discectomy
Zero-profile interbody fusion device
