新型颈椎前路滑动钢板在多节段颈椎病ACDF术中的应用  

A comparative study of a new type of cervical anterior sliding plate in ACDF for treatment of multi-segment cervical spondylosis

作　　者：邓超 韩应超 劳立峰[1] 陈智 陈建伟[1] 钟贵彬[1] 刘祖德[1] 沈洪兴 DENG Chao;HAN Ying-chao;LAO Li-feng;CHEN Zhi;CHEN Jian-wei;ZHONG Gui-bin;LIU Zu-de;SHEN Hong-xing(Department of Spine Surgery,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院脊柱外科

出　　处：《中国骨与关节损伤杂志》2019年第7期673-676,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较新型颈椎前路滑动钢板(Atlantis Translational)与常规颈椎前路钢板(Skyline)在颈椎前路椎间盘切除减压融合内固定(ACDF)术中应用的效果。方法回顾性分析自2017-06-2018-09行ACDF手术治疗的36例多节段颈椎病,16例术中采用新型颈椎前路滑动钢板内固定(滑动钢板组),20例术中采用常规颈椎前路钢板内固定(常规钢板组)。比较2组手术时间、术中出血量、椎间融合时间、并发症情况,以及术后JOA评分、颈椎Cobb角、NDI指数及Odom评分。结果 36例均获得随访,随访时间平均12(8~16)个月。滑动钢板组手术时间较常规钢板组短,术中出血量较常规钢板组少,椎间融合时间较常规钢板组短,差异有统计学意义(P <0.05)。滑动钢板组与常规钢板组术后3 d、6个月、末次随访时JOA评分、颈椎Cobb角、NDI指数,以及并发症发生率、末次随访时Odom评分差异无统计学意义(P>0.05)。结论新型颈椎前路滑动钢板由于其独特设计结构可满足不同患者解剖和生物力学需求,在ACDF治疗多节段颈椎病术中应用操作更简单,能够明显缩短手术时间,减少手术创伤,促进椎间融合。Objective To compare the effects of new cervical anterior sliding plate(Atlantis Translational) and conventional anterior cervical plate(Skyline) in anterior cervical discectomy and fusion(ACDF) surgery. Methods Retrospective analysis of 36 cases of multi-segment cervical spondylosis treated with ACDF surgery from June 2017 to September 2018 was conducted, including 16 cases of cervical anterior sliding plate fixation(sliding plate group), and 20 cases of conventional anterior cervical vertebrae plate internal fixation(conventional plate group). The operation time, intraoperative blood loss,interbody fusion time, complications, postoperative JOA score, cervical Cobb angle, NDI index and Odom score were compared between the two groups. Results All 36 patients were followed up for an average of 12(8-16) months. The operation time of the sliding plate group was shorter than that of the conventional plate group. The intraoperative blood loss of the sliding plate group was less than that of the conventional plate group, and the interbody fusion time was shorter than that of the conventional plate group. The differences were statistically significant(P <0.05). There was no significant difference in JOA score, cervical Cobb angle, NDI index, complication rate and Odom score at the last follow-up between 3 days and 6 months after operation between the sliding plate group and the conventional plate group(P >0.05). Conclusion The new cervical anterior sliding plate can meet the different anatomical and biomechanical requirements of patients due to its unique design structure. It is easier to use in the treatment of multi-segment cervical spondylosis with ACDF, which can significantly shorten the operation time, reduce the surgical trauma and promote intervertebral fusion..

关 键 词：多节段颈椎病 颈椎间盘退变 颈椎前路减压融合内固定术 新型颈椎前路滑动钢板 

分 类 号：R681.5[医药卫生—骨科学]