摘要
目的探讨零切迹颈椎融合器ROI-C和传统的钛板融合器系统治疗单节段脊髓型颈椎病的临床疗效。方法分析2016年11月至2018年11月郑州大学第一附属医院骨科行颈前路椎间盘切除减压融合术的70例单节段脊髓型颈椎病患者的临床资料,根据手术方式不同分为ROI-C组和钛板-融合器组。随访内容包括:一般情况和术后并发症、术前和术后患者的日本骨科学会颈椎病评分(JOA评分)、术前和术后患者的颈椎曲度、术后手术节段椎间融合情况和邻近节段的退变情况。计数资料比较使用χ^2检验,计量资料组内数据比较采用配对样本t检验。结果两组患者术后的JOA评分和术前比较均有提高(ROI-C组术前、术后1个月、术后6个月、术后1年的JOA评分为5.94±1.56、12.66±0.79、13.69±0.78、14.41±0.61;钛板-融合器组术前、术后1个月、术后6个月、术后1年的JOA评分为6.21±1.36、13.00±1.14、13.68±0.87、14.32±0.74),差异有统计学意义(t=-27.675、-29.601、-31.441、-33.338、-33.148、-40.052,P<0.05),但是术后同时间点两组患者的JOA评分差异无统计学意义(t=-0.781、-1.441、0.016、0.550,P>0.05);两组患者术后的颈椎Cobb角和术前比较均有改善(ROI-C组术前、术后1个月、术后6个月、术后1年的颈椎Cobb角为8.14±0.50、16.76±0.72、15.86±0.59、14.94±0.56;钛板-融合器组术前、术后1个月、术后6个月、术后1年的颈椎Cobb角为8.11±0.58、16.62±0.69、15.86±0.72、14.92±0.69),差异有统计学意义(t=-52.937、-48.922、-43.901、-66.986、-57.391、-53.618,P<0.05),但是术后同时间点两组患者的颈椎Cobb角差异无统计学意义(t=0.247、0.808、-0.007、0.091,P>0.05);末次随访时两组患者手术节段椎间均融合,未见邻近节段退变。结论使用ROI-C和传统的钛板融合器系统行颈前路椎间盘切除减压融合术治疗单节段脊髓型颈椎病均可获得满意的临床疗效,但使用ROI-C手术时间短,术中出血量少,术后吞咽困难的发生率较低。
Objective To evaluate the clinical efficacy of zero-profile anchored spacer(ROI-C)and conventional titanium plate with cage fixation for the treatment of single-segment cervical spondylotic myelopathy.Methods A total of 70 patients with single-segment cervical spondylotic myelopathy underwent the anterior cervical discectomy and fusion surgery.The patients were divided into ROI-C group and plate-cage group according to the surgical procedures.During the follow-up period,general situations,the postoperative complications,preoperative and postoperative Japanese Orthopaedic Association(JOA)score,preoperative and postoperative cervical curvature,postoperative intervertebral fusion and adjacent segment degeneration were observed.Results In two groups,the JOA score was improved statistically(ROI-C group:5.94±1.56,12.66±0.79,13.69±0.78,14.41±0.61;plate-cage group:6.21±1.36,13.00±1.14,13.68±0.87,14.32±0.74;t=-27.675,-29.601,-31.441,-33.338,-33.148,-40.052,P<0.05),tut there was no statistically significant difference between two groups at the same time(t=-0.781,-1.441,0.016,0.550,P>0.05).Also,the Cobb angle was improved statistically(ROI-C group:8.14±0.50,16.76±0.72,15.86±0.59,14.94±0.56;plate-cage group:8.11±0.58,16.62±0.69,15.86±0.72,14.92±0.69;t=-52.937,-48.922,-43.901,-66.986,-57.391,-53.618,P<0.05),but there was no statistically significant difference between two groups(t=0.247,0.808,-0.007,0.091,P>0.05)at the same time.At the last follow-up,postoperative intervertebral fusion and no adjacent segment degeneration was observed in both groups.Conclusion Both ROI-C and conventional titanium plate with cage fixation can achieve satisfied clinical efficacy in ACDF for the treatment of single-segment cervical spondylotic myelopathy.The operation time is shorter,blood loss is less and incidence of postoperative dysphagia is lower in ROI-C group.
作者
李建强
肖鹏
吴学建
Li Jianqiang;Xiao Peng;Wu Xuejian(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2020年第2期360-362,共3页
Chinese Journal of Experimental Surgery
