Zero-P与传统钛板固定融合对术后相邻节段退变的影响对比  

Influence Comparison of Zero-P and Traditional Ttitanium Plates on Degeneration of Adjacent Segments after Operation

作　　者：刘懿锋 LIU Yifeng(Department of the third orthopedics,Center hospital of Chaoyang city,Chaoyang,Liaoning 122000)

机构地区：[1]朝阳市中心医院骨三科,辽宁朝阳122000

出　　处：《中国伤残医学》2023年第23期11-15,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:研究对比颈前路零切迹椎间融合器(Zero-P)与传统钛板固定融合对术后相邻节段退变的影响。方法:将医院2017年1月一2020年1月收治的144例脊髓型颈椎病患者纳入研究。将其按照治疗方式的差异分作观察组80例及对照组64例。所有受试者均实施颈椎前路椎间盘切除融合术(ACDF)治疗。其中观察组实施Zero-P固定融合,对照组则开展传统钛板固定融合。分析2组相关手术指标,日本骨科学会(JOA)及视觉模拟评分法(VAS)评分变化情况,上、下相邻椎间隙高度,相邻节段椎间盘退变情况等方面的差异。此外,对比2组患者末次随访时相邻椎体骨化发生情况。结果:观察组单节段、双节段手术时长均低于对照组(均P<0.05);2组末次随访JOA评分均高于术前,而VAS评分均低于术前(均P<0.05),2组术前、末次随访的JOA及VAS评分对比均不明显(均P>0.05);观察组末次随访双节段上、下相邻椎间隙高度均高于同时间点对照组双节段(均P<0.05);观察组双节段相邻椎间盘退变总发生率为3.45%,低于对照组双节段的23.08%(P<0.05);观察组单节段患者末次随访时相邻椎体骨化总发生率为3.92%(2/51),低于对照组的26.32%(10/38),且观察组双节段患者末次随访时相邻椎体骨化总发生率为3.45%(1/29),低于对照组的30.77%(8/26)(χ^(2)值=9.361、7.477,P值=0.002、0.006)。结论:Zero-P与传统钛板固定融合手术应用于脊髓型颈椎病患者的效果相当,但前者术后相邻节段退变发生风险更低。Objective:To compare the effects of anterior cervical zero-notch interbody fusion(ZERO-P)and traditional titanium plate fixation and fusion on postoperative degeneration of adjacent segments.Methods:A total of 144 patients with cervical spondylotic myelopathy admitted to our hospital from January 2017 to January 2020 were included in the study.The patients were divided into study group(n=80)and conventional group(n=64)according to the difference of treatment methods.Allsubjects underwent anterior cervical discectomy and fusion(ACDF).Zero-P fixation fusion was performed in the research group,while traditional titanium plate fixation fusion was performed in the traditional group.The differences between the two groups were analyzed in terms of relevant surgical indicators,the changes of Japanese Orthopaedic Society(JOA)and visual analog scale(VAS)scores,the height of upper and lower adjacent intervertebral Spaces,and the degeneration of intervertebral discs at adjacent segments.In addition,the incidence of adjacent vertebral ossification was compared between the two groups at the last follow-up.Results:The operative duration of single and double levels in the study group was lower than that in the conventional group(all P<O.05).The JOA score at the last follow-up was higher than that before surgery,while the VAS score was lower than that before surgery(all P<0.05).The comparison of JOA and VAS scores before and at the last follow-up between the two groups was not significant(all P>0.05).In the last follow-up,the height of adjacent intervertebral Spaces at both upper and lower levels in the study group was higher than that in the conventional group at the same time point(all P<0.05).The total incidence of intervertebral disc degeneration in the study group was 3.45%,which was lower than 23.08% in the conventional group(P<0.05).The total incidence of adjacent vertebral ossification was 3.92%(2/51)in single-segment patients of the study group at the last fllow-up,lower than 26.32%(10/38)in the conventional group,and th

关 键 词：颈椎前路椎间盘切除融合术 零切迹椎间融合器 钛板固定融合 相邻节段退变 

分 类 号：R681.5[医药卫生—骨科学]