Zero-P前路颈椎减压融合术临床与影像研究  

A clinical and radiographic study on single-level anterior cervical decompression and fusion with Zero-P device

作　　者：叶福标[1] 尹晓明[1] 林飞跃[1] 徐杨[1] YE Fu-biao;YIN Xiao-ming;LIN Fei-yue;XU Yang(Department of Orthopaedics,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院骨科,福州350001

出　　处：《中国矫形外科杂志》2020年第5期395-399,共5页Orthopedic Journal of China

基　　金：福建省卫计委中青年骨干人才培养项目(编号:2017-ZQN-8);福建省立医院“创双高”火石基金项目(编号:2019HSJJ02)。

摘　　要：[目的]探讨Zero-P系统在单节段前路颈椎减压融合术(ACDF)的临床与影像学结果。[方法]回顾分析35例采用Zero-P系统的行ACDF术的患者。记录围手术期和随访资料,影像测量颈椎前凸角(CL),手术节段前凸角(OL);融合节段前缘高度(AIH)和融合节段后缘高度(PIH)。[结果] 35例患者均顺利手术,术中末发生重要血管、神经、器官损伤,无硬膜撕裂。35例患者随访9~42个月,平均(23.29±13.42)个月。末次随访35例患者病理发射较术前显著减轻,差异有统计学意义(P<0.05)。末次随访时VAS和NDI评分较术前显著减小,差异均有统计学意义(P<0.05)。影像评价方面,CL由术前的(18.29±8.43)°增加到术后6个月的(19.18±10.72)°,末次复查的(23.06±7.13)°(P<0.05)。OL由术前(8.23±4.54)°,增加至术后(14.23±5.11)°(P<0.01),而末次随访时又减少至(11.24±5.16)°,不同时间点间差异有统计学意义(P<0.05)。AIH由术前(33.24±4.61) mm,显著增加至术后6个月的(36.57±4.78) mm(P<0.05),末次随访时又减少至(35.16±4.81) mm,差异无统计学意义(P>0.05)。而PIH术前、术后初次复查和末次随访时无显著改变(P>0.05)。至末次随访时,融合率为91.43%。[结论] Zero-P系统ACDF可以保证良好的融合率,能明显改善C2-7的颈椎生理前凸,但在改善融合节段生理曲度和椎间高度方面并不理想。[Objective] To investigate the clinical and radiographic outcomes of single segment anterior cervical decompression and fusion(ACDF) with Zero-Profile interbody fusion device. [Methods] A retrospective study was conducted on 35 patients who underwent ACDF with Zero-P devices. The perioperative and follow up data were recorded, and radiographic measurements, including cervical lordosis(CL), operated segment lordosis(OL), anterior interbody height(AIH) and posterior interbody height(PIH) of the segment fused, were conducted. [Results] All the patients had operation performed smoothly without iatrogenic injury to the vessel, nerve and dural sac during operation, and followed up for 9~42 months with a mean of(23.29±13.42) months. The VAS and NDI scores significantly decreased at the latest interview compared with those preoperatively(P<0.05). With respect to radiographic assessments, the CL increased from(18.29±8.43)° preoperatively to(19.18±10.72)° at initial follow-up after operation and(23.06±7.13)° at the latest follow-up, which was statistically significant(P<0.05). In addition,the OL significantly increased from(8.23±4.54)° before operation to(14.23±5.11)° at initial follow-up after operation(P<0.05),and then reduced to(11.24±5.16)° at the latest follow up(P<0.05). Furthermore, AIH significantly increased from(33.24±4.61)mm before operation to(36.57± 4.78) mm at initial follow-up(P<0.05), subsequently decreased slightly to(35.16± 4.81) mm at latest follow-up(P>0.05). Moreover, PIH remained unchanged among time points before operation, at initial follow-up and the latest follow-up(P>0.05). Finally, the fusion rate proved of 91.43% to the latest follow up. [Conclusions]The ACDF with ZeroP device does achieve high fusion rate and recovery of physiological lordosis of C2-7 cervical spine, but its capacity to maintain intervertebral height is not desirable to clinical setting.

关 键 词：前路颈椎减压融合术(ACDF) Zero-P椎间融合器 矢状面 生理曲度 

分 类 号：R681.55[医药卫生—骨科学]