颈前路椎间盘切除减压融合术中应用零切迹自稳型融合器和融合器并钛板内固定的临床疗效比较  

Comparison of the clinical effectiveness of zero-profile anchored spacer ROI-C and traditional titanium plate combined with cage in ACDF

作　　者：李宁 周悦 刘猛 刘永涛 黄栋 辛兵 LI Ning;ZHOU Yue;LIU Meng;LIU Yongtao;HUANG Dong;XIN Bing(Department of Orthopedics,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China;Graduate School,Xuzhou Medical University,Xuzhou,Jiangsu 221004)

机构地区：[1]徐州医科大学附属医院骨科,江苏徐州221002 [2]徐州医科大学研究生院,江苏徐州221004

出　　处：《徐州医科大学学报》2021年第1期45-50,共6页Journal of Xuzhou Medical University

摘　　要：目的分析并比较颈前路椎间盘切除减压融合术(ACDF)中应用零切迹自稳型融合器(ROI-C)与融合器并钛板内固定的临床疗效。方法选取2015年4月—2017年6月徐州医科大学附属医院采用ACDF治疗颈椎退行性疾病患者83例,其中ROI-C固定治疗41例(ROI-C组,A组),融合器并钛板固定治疗42例(融合器并钛板组,B组)。比较2组患者的手术时间、术中出血量及并发症发生情况。在术前、术后3个月及末次随访时,采用日本骨科学会评分(JOA)及颈椎功能障碍指数(NDI)评估患者颈椎功能,Odom法对2组进行手术疗效评定,Bazaz分级系统记录2组吞咽困难情况,X线、CT记录2组颈椎Cobb角、病变椎间高度、融合情况及邻近节段异位骨化情况。结果ROI-C组平均随访时间(45.6±7.4)个月,融合器并钛板组平均随访时间(44.2±6.2)个月。ROI-C组患者手术时间、术中出血量、术后吞咽困难发生率及邻近节段骨化发生率均明显低于融合器并钛板组。2组患者术后JOA、NDI评分较术前均明显改善(P<0.05)。2组患者术后均恢复颈椎生理曲度。结论ACDF中应用ROI-C能有效恢复颈椎生理曲度,并发症少,患者疗效满意,是一种安全有效的治疗颈椎退行性疾病的方法。Objective To compare the clinical effectiveness of zero-profile anchored spacer(ROI-C)and titanium plate combined with cage during anterior cervical discectomy and fusion(ACDF).Methods A total of 83 patients who were admitted into the Affiliated Hospital of Xuzhou Medical University and underwent ACDF due to cervical degenerative diseases from April 2015 to June 2017 were enrolled.There were 41 patients who received ROI-C fixation(the ROI-C group,group A)and 42 patients who were fixed with titanium plate combined with cage(the titanium plate combined with cage group,group B).Then,both groups were compared for operation time,intraoperative blood loss and complications.Furthermore,before surgery,3 months after surgery and at the ending of final follow-up,their cervical function was evaluated by the Japanese Orthopedic Association(JOA)scores,neck disability index(NDI);the surgical efficacy was evaluated by the Odom criteria;the postoperative dysphagia was assessed by the Bazaz grading system;the cervical Cobb angle,intervertebral space,cervical fusion and adjacent-level ossification development were assessed by X-ray and CT.Results The mean follow-up time was(45.6±7.4)months for the ROI-C group and(44.2±6.2)months for the titanium plate combined with cage group.The ROI-C group presented remarkable decreases in operation time,intraoperative blood loss,postoperative dysphagia incidence,and adjacent-level ossification incidence,compared with the titanium plate combined with cage group(P<0.05).After surgery,both groups showed significantly improved JOA and NDI scores,compared with those before surgery(P<0.05).The cervical physiological curvature was effectively restored in both groups after surgery.Conclusions The use of ROI-C in ACDF can effectively restore the cervical physiological curvature,with fewer complications and satisfactory effectiveness,which is an effective and reliable method to treat cervical degenerative disc disease.

关 键 词：ROI-C融合器 颈椎病 颈前路钢板 吞咽困难 相邻节段骨化 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]