颈椎前路零切迹融合器治疗无骨折脱位老龄急性颈髓中央综合征的疗效分析  

Efficacy Analysis of Anterior Cervical Zero-profile Fusion Device in the Treatment of Elderly Patients with Cervical Acute Traumatic Central Cord Syndrome Without Fracture or Dislocation

作　　者：宋达玮[1] 武岑颢 颜奇 王英杰 于浩 杨明[1] 杨炎[1] 王金宁[1] 钮俊杰 SONG Da-wei;WU Cen-hao;YAN Qi;WANG Ying-jie;YU Hao;YANG Ming;YANG Yan;WANG Jin-ning;NIU Jun-jie(Department of Orthopedics,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《中国血液流变学杂志》2021年第3期320-326,共7页Chinese Journal of Hemorheology

基　　金：国家自然科学基金资助项目(81902181)。

摘　　要：目的探究自锁定式零切迹椎间融合器ROI-C治疗老龄急性颈髓中央综合征的疗效。方法回顾性地分析了使用零切迹ROI-C融合器治疗年龄60岁及以上的16例急性颈髓中央综合征患者资料,将患者术前、术后及各随访时间点的评估指标进行对比,分别使用美国脊髓损伤协会评分、颈椎功能障碍指数、日本骨科协会评估治疗评分评估临床症状的改善情况,使用手术节段椎间隙高度,颈椎前凸角度评估影像学改善情况。结果所有纳入随访的患者均顺利完成手术,具有较低的吞咽困难发生率(6.25%),未出现内固定断裂、融合器下沉、邻近节段退变等并发症,患者美国脊髓损伤协会评分、颈椎功能障碍指数、日本骨科协会评估治疗评分较术前有明显好转(P<0.05)。患者术后手术节段椎间隙高度,颈椎前凸角度较术前好转,差异具有统计学意义(P<0.05),且在随访过程中仍能维持,差异无统计学意义(P>0.05)。结论零切迹ROI-C融合器在短期随访时间内能够安全有效地应用于老龄无骨折脱位急性颈髓中央综合征患者,提供足够的稳定性以及较少的并发症,是一种具有一定应用前景及研究意义的治疗方法。Objective To investigate the clinical efficacy of ROI-C in the treatment of elderly patients with cervical acute traumatic central cord syndrome.Methods The data of 16 patients aged 60 years and above who were treated with zero-profile ROI-C fusion device were retrospectively analyzed,and the evaluation indexes of the patients preoperatively,postoperatively and at each follow-up time were compared.The improvement of clinical symptoms was assessed using the American Spinal Injury Association(ASIA)Impairment Score,the Neck Disability Index(NDI),and the Japanese Orthopaedic Association(JOA)Evaluation Treatment Score,respectively.Imaging improvement was assessed using the surgical segment intervertebral disc height and the cervical lordosis Angle.Results All the patients included in the follow-up completed the operation successfully with low dysphagia rate(6.25%),and there were no complications such as internal fixation fracture,fusion cages sinking,and adjacent segment degeneration.The score of the ASIA Impairment Score,NDI,and the evaluation and treatment score of JOA were significantly improved compared with those preoperatively(P<0.05).Improvements were observed in both postoperative surgical segments intervertebral height and cervical lordosis angle with statistically significant difference(P<0.05),which maintained during the process of follow-up.There was no statistically significant difference(P>0.05).Conclusion The results prompted to zero-profile ROI-C fusion device can be safe and effective in short-term follow-up time in elderly patients with acute cervical traumatic central cord syndrome without fracture or dislocation as it can provide sufficient stability and less complications,which is a therapeutic method with certain application prospect and research significance.

关 键 词：急性颈髓中央综合征 零切迹ROI-C融合器 颈椎前路椎间隙减压融合术 骨科植入物 吞咽困难 

分 类 号：R651.2[医药卫生—外科学]