颈椎前路椎间盘切除融合术中采用零切迹椎间融合器与钉板系统治疗单节段颈椎椎间盘突出症对术后颈椎曲度的影响  

Effect of zero-profile anchored spacer and plate-cage construct in anterior cervical discectomy and fusion for single segment cervical disc herniation on postoperative cervical curvature

作　　者：刘刚 田野 沈晓龙 曹鹏 袁文 LIU Gang;TIAN Ye;SHEN Xiao-long;CAO Peng;YUAN Wen(Department of Orthopaedics,Changzheng Hospital,Navy Medical University,Shanghai 200003,China)

机构地区：[1]海军军医大学附属长征医院骨科,上海200003

出　　处：《脊柱外科杂志》2020年第4期243-247,252,共6页Journal of Spinal Surgery

摘　　要：目的比较颈椎前路椎间盘切除融合术(ACDF)中采用零切迹椎间融合器(Zero-P)与钉板系统(PCC)治疗单节段颈椎椎间盘突出症对术后颈椎曲度的影响。方法回顾性分析2016年5月—2018年3月在本院接受ACDF治疗的136例单节段颈椎椎间盘突出症患者临床资料,其中71例术中采用Zero-P(Zero-P组),65例采用PCC(PCC组)。记录2组手术时间,术中出血量,术前及术后1、6、12和24个月日本骨科学会(JOA)评分、疼痛视觉模拟量表(VAS)评分、C2~7颈椎曲度、手术节段Cobb角及邻近椎体高度,术后植骨融合及内固定相关并发症情况。结果所有手术顺利完成,Zero-P组手术时间明显短于PCC组,差异有统计学意义(P<0.05)。2组患者术后JOA评分、VAS评分、C2~7颈椎曲度、手术节段Cobb角及邻近椎体高度均较术前显著改善,差异有统计学意义(P<0.05)。术后24个月,Zero-P组C2~7颈椎曲度、手术节段Cobb角和邻近椎体高度较术后1个月降低,与PCC组相比差异亦有统计学意义(P<0.05)。结论ACDF术中采用PCC可获得与Zero-P相同的临床效果,虽然PCC在控制手术时间方面不如Zero-P组,但可更好地维持颈椎曲度。Objective To compare the effects of zero-profile anchored spacer(Zero-P)and plate-cage construct(PCC)in anterior cervical discectomy and fusion(ACDF)for single segment cervical disc herniation on postoperative cervical curvature.Methods The clinical data of 136 patients with single segment cervical disc herniation treated by ACDF from May 2016 to March 2018 were retrospectively analyzed.Among them,71 were treated by Zero-P(Zero-P group),and 65 by PCC(PCC group).The operation time,intraoperative blood loss,Japanese Orthopaedic Association(JOA)score,visual analogue scale(VAS)score,C2-7 cervical curvature,Cobb's angle of operative segment and adjacent vertebral height at pre-operation and postoperative 1,6,12 and 24 months,bone graft fusion and postoperative complications related to internal fixation were recorded.Results All the operations were successfully completed.The operation time of Zero-P group was significantly shorter than that of PCC group,and the difference was statistically significant(P<0.05).The JOA score,VAS score,C2-7 cervical curvature,Cobb's angle of operative segment and adjacent vertebral height of the 2 groups were significantly improved after operation compared with before operation,and the differences were statistically significant(P<0.05).In the Zero-P group,C2-7 cervical curvature,Cobb's angle of operative segment and adjacent vertebral height were lower at postoperative 24 months than at postoperative 1 month,and the difference was also statistically significant compared with the PCC group(P<0.05).Conclusion Using PCC in ACDF can achieve the same clinical effect as Zero-P.Although PCC is not as good as Zero-P in controlling operation time,it can maintain better cervical curvature.

关 键 词：颈椎 椎间盘退行性变 椎间盘切除术 脊柱融合术 手术后并发症 

分 类 号：R681.531[医药卫生—骨科学]