采用前路自锁式自稳型零切迹颈椎融合器治疗连续双节段脊髓型颈椎病的临床效果  

Clinical effects of anterior cervical zero-profile anchored spacer for the treatment of continuous two-segment cervical spondylotic myelopathy

作　　者：孙中仪 杨宁涛 田纪伟 Sun Zhongyi;Yang Ningtao;Tian Jiwei(Department of Orthopedics, Nanjing Jiangbei Hospital, Nanjing 210048, China;不详)

机构地区：[1]南京江北医院骨科,210048 [2]淄博市中西医结合医院骨科,255026

出　　处：《骨科临床与研究杂志》2022年第2期74-79,共6页Journal Of Clinical Orthopedics And Research

基　　金：南京市卫生科技发展专项医药卫生科研课题(YKK20182)。

摘　　要：目的探讨前路自锁式自稳型零切迹颈椎融合器(ROI-C)治疗连续双节段脊髓型颈椎病的临床疗效。方法对2018年1月至2020年6月南京江北医院骨科采用颈椎前路椎间盘切除减压植骨融合术(ACDF)治疗的连续双节段脊髓型颈椎病患者85例的临床资料进行回顾性分析。依据固定方式将全部患者分为ROI-C固定组(简称ROI-C组)和融合器联合钛板固定组(简称钛板组)。ROI-C组包括患者45例,男25例,女20例,年龄(60.01±8.73)(42~73)岁,病灶节段C4-C618例、C5-C727例。钛板组包括患者40例,男18例,女22例,年龄(59.32±8.12)(40~70)岁,病灶节段C4-C619例、C5-C721例。对两组患者的手术时间,术中出血量,术前、术后1个月与术后6个月颈椎Cobb角和手术节段前凸角,日本骨科学会(JOA)评分,颈部和手臂疼痛视觉模拟评分(VAS)以及术后吞咽困难发生率进行比较。应用SPSS 20.0软件对数据进行统计学分析;P<0.05为差异有统计学意义。结果全部患者获得(10.77±3.03)(6~18)个月随访。ROI-C组和钛板组手术时间分别为(95.3±21.9)min和(118.3±34.4)min,术中出血量分别为(63.6±14.1)ml和(89.2±22.6)ml,差异均有统计学意义(均P<0.05)。ROI-C组术后末次随访JOA评分为(14.8±1.3)分,VAS评分为(1.6±0.4)分,手术节段前凸角为(9.6±5.5)°,Cobb角为(21.9±6.2)°,较术前均有显著改善(均P<0.05);钛板组末次随访JOA评分为(14.5±1.0)分,VAS评分为(1.6±0.3)分,手术节段前凸角为(9.1±4.1)°,Cobb角为(20.6±7.3)°,较术前均有显著改善(均P<0.05);2组间差异均无统计学意义(均P>0.05)。术后患者发生吞咽困难的发生率ROI-C组为4.4%(2/45),钛板组为22.5%(9/40),差异有统计学意义(P<0.05)。结论与融合器联合钛板固定相比,应用颈椎前路ROI-C固定治疗连续双节段脊髓型颈椎病同样安全有效,同时可减少手术时间和术中出血量,并降低术后吞咽困难发生率。Objective To investigate the clinical effect of anterior cervical zero-profile anchored spacer(ROI-C)in the treatment of continuous two-segment cervical spondylotic myelopathy.Method The clinical data of 85 patients with continuous two-segment cervical spondylotic myelopathy treated with anterior cervical discectomy,decompression,bone grafting and fusion(ACDF)from January 2018 to June 2020 were analyzed retrospectively.All patients were divided into 2 groups(the ROI-C group and the titanium plate group)according to their fixation method.The ROI-C group included 45 patients,25 males and 20 females,aged(60.01±8.73)(42-73),and the lesion segments were C4-C6 in 18 cases and C5-C7 in 27 cases.The titanium plate group included 40 patients,18 males and 22 females,aged(59.32±8.12)(40-70),and the lesion segments were C4-C6 in 19 cases and C5-C7 in 21 cases.The operation time and operative blood loss were recorded and compared between the 2 groups.The preoperative and postoperative Cobb's angle,the lordosis angle of the operation segment,the Japanese Orthopaedic Association(JOA)score and visual analogue scale(VAS)of neck and arm pain were measured and compared between the 2 groups.Postoperative dysphagia was recorded using Bazaz scores and compared between the 2 groups.Result The follow-up duration was(10.77±3.03)(6-18)months.The operation time was(95.3±21.9)min,(118.3±34.4)min and the operative blood loss was(63.6±14.1)ml,(89.2±21.9)min in the ROI-C group and the titanium plate group,respectively,and the differences were all statistically significant(all P<0.05).At the last follow-up,the value of the evaluation indice in ROI-C group were the JOA(14.8±1.3)scores,VAS(1.6±0.4)scores,lordosis angle of surgical segment(9.6±5.5)°and the Cobb's angle(21.9±6.2)°,and all were improved compared with that before operation(all P<0.05).At the last follow-up,the value of the evaluation indice in the titanium plate group were JOA(14.5±1.0)scores,VAS(1.6±0.3)scores,lordotic angle of surgical segment(9.1±4.1)°and Cobb's a

关 键 词：颈椎 脊髓压迫症 脊柱融合术 椎间盘切除术 自锁式自稳型零切迹颈椎融合器 

分 类 号：R68[医药卫生—骨科学]