Peek-Prevail融合器与钢板内固定治疗单节段颈椎病的效果观察  

Peek-Prevail interbody fusion cage versus plate internal fixation for single segment cervical spondylosis

作　　者：刘进[1] 张宇[1] 顾祖超[1] 于圣会[1] Liu Jin;Zhang Yu;Gu Zuchao;Yu Shenghui(Department of Orthopedics,Chengdu First People's Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]成都市第一人民医院骨科

出　　处：《现代临床医学》2019年第5期347-351,共5页Journal of Modern Clinical Medicine

摘　　要：目的:对比Peek-Prevail融合器与钢板内固定治疗单节段颈椎病的临床疗效。方法:选取2014年1月至2016年6月我科治疗单节段颈椎疾病40例患者为研究对象,按固定融合方式不同分为两组,Peek-Prevail固定组(A组)和钢板固定组(B组)。于手术前、后及末次随访时分别进行日本骨科协会评分(JOA)、疼痛视觉模拟评分(VAS)、吞咽情况评估,并拍摄X线片测量手术近远端节段椎间隙高度、椎间活动度。结果:两组手术持续时间、术中出血量比较无显著性差异(P> 0. 05);VAS评分、JOA评分末次随访时均显著优于同组术前(P <0. 01);术前与末次随访时近、远端节段椎间隙高度及颈椎活动度A组与B组比较无显著性差异(P> 0. 05),但B组近端节段椎间隙高度末次随访时显著低于术前(P <0. 05),B组末次随访时颈椎活动度显著大于术前(P <0. 05);A组术后出现吞咽异物感1例,术后3个月时缓解;B组出现吞咽困难2例,末次随访时仍有1例患者存在重度吞咽困难。结论:Peek-Prevail融合器与钢板内固定治疗单节段颈椎病的临床疗效相当,但前者对术后吞咽功能、邻近节段活动度等影响更小,其长期优势仍有待进一步观察。Objective:To compare the efficacy of Peek-Prevail zero-profile cervical interbody fusion cage and traditional anterior cervical plate internal fixation in the treatment of single segment cervical spondylosis.Methods:From January 2014 to June 2016,we retrospectively studied the data of patients with single segment cervical spondylosis treated with Peek-Prevail zeroprofile cervical interbody fusion cage(group A,15 cases)and traditional anterior cervical interbody fusion plate(group B,25 cases).JOA score,VAS score and swallowing condition were evaluated before,after and at the last follow-up.X-ray was taken to measure the height of upper and lower intervertebral space and intervertebral motion.Results:There were no significant differences in operation duration and blood loss between the two groups(all P>0.05).VAS score and JOA score were significantly improved at the last follow-up(P<0.01).There were no significant differences between group A and group B in the height of proximal and distal intervertebral space and the cervical mobility before operation and at the last follow-up(P>0.05),but the height of proximal intervertebral space at the last follow-up was significantly lower than that in group B before operation(P<0.05),and the cervical mobility was significantly higher at the last follow-up than that before operation in group B(P<0.05).In group A,swallowing foreign body sensation occurred in a case,which was relieved at 3 months after operation;in group B,swallowing difficulty occurred in 2 cases,and severe swallowing difficulty still existed in a case at the last follow-up.Conclusion:Peek-Prevail zero-profile interbody fusion cage for cervical interbody fusion is as effective as traditional anterior cervical plate in the treatment of single segment cervical spondylosis,but the former has less effect on postoperative swallowing function,and its mid-term and longterm advantages need to be further observed.

关 键 词：Peek-Prevail融合器 钢板内固定 单节段颈椎病 

分 类 号：R681.5[医药卫生—骨科学]