零切迹椎间融合器与微型钢板在颈椎管狭窄症一期前后路联合手术中应用的疗效观察  

Observation of effectiveness of zero-notch interbody fusion apparatus and microplate in one-stage combined anteroposterior cervical surgery for cervical spinal stenosis

作　　者：辛大森 程才[1] 孙洪江[1] 高书明[1] 刘广飞[1] 李勇[1] 陈汉文[1] 赵跃江[1] XIN Dasen;CHENG Cai;SUN Hongjiang;GAO Shuming;LIU Guangfei;LI Yong;CHEN Hanwen;ZHAO Yuejiang(Department of Orthopedics,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院骨一科,河北061000

出　　处：《中国骨与关节损伤杂志》2024年第1期12-16,共5页Chinese Journal of Bone and Joint Injury

基　　金：河北省医学科学研究课题计划(20210205);沧州市中心医院重点研究课题(2020018)。

摘　　要：目的 研究颈椎前路零切迹椎间融合器与后路单开门椎管减压微型钢板内固定在颈椎管狭窄症一期前后路联合手术中应用的疗效及安全性。方法 回顾性分析自2017-03—2021-02采用一期前后路联合手术治疗的64例颈椎管狭窄症,颈椎前路采用零切迹椎间融合器固定,颈椎后路行单开门椎管减压微型钢板内固定。比较术前与术后1年颈椎JOA评分、疼痛VAS评分、NDI指数、手术节段椎间隙高度、颈椎曲度。结果 64例均获得随访,随访时间12~60个月,平均25个月。术后所有患者脊髓功能明显改善,未出现颈前不适感、吞咽困难、颈后轴性疼痛等症状。术后3个月MRI显示颈椎管扩大良好,脊髓前后压迫均完全解除。术后1年颈椎CT显示手术节段椎间隙融合良好,椎板单开门状态维持良好,无再关门现象发生。术后1年X线片显示颈椎生理曲度维持良好,未出现内固定松动、断裂。术后1年神经功能JOA评分、疼痛VAS评分、NDI指数、手术节段椎间隙高度、颈椎曲度较术前明显改善,差异有统计学意义(P<0.05)。结论 颈椎前路零切迹椎间融合器与后路微型钢板的应用有利于颈椎管狭窄症一期前后路联合手术更广泛开展,手术安全性提高,可以有效避免传统内固定物相关并发症,进而使更多患者受益。Objective To investigate the efficacy and safety of anterior zero notch interbody fusion apparatus and posterior sin⁃gle door decompression microplate internal fixation in one-stage combined anteroposterior surgery for cervical spinal stenosis.Methods The clinical data of 64 patients with cervical spinal stenosis from March 2017 to February 2021 were retrospectively analyzed.Zero notch interbody fusion apparatus was used for anterior cervical surgery.A microplate was used for posterior cervi⁃cal single door decompression.The cervical JOA score,pain VAS score,NDI index,surgical space height and cervical curvature were compared before and 1 year after surgery.Results All 64 cases were followed up for 12 to 60 months,with an average of 25 months.After operation,the spinal cord function of all patients was significantly improved,and there were no symptoms such as anterior neck discomfort,dysphagia,and posterior cervical axial pain.Three months after surgery,MRI showed that the cervi⁃cal canal was well enlarged and the spinal cord compression was completely relieved.One year after the operation,cervical CT showed that the intervertebral space fusion was good,the single opening of the lamina was maintained well,and no re-closing occurred.One year after the operation,the X-ray film showed that the physiological curvature of the cervical spine was well maintained,and there was no loosening or fracture of internal fixation.One year after surgery,neurological function JOA score,pain VAS score,NDI index,intervertebral space height and cervical curvature were significantly improved compared with those before surgery,with statistical significance(P<0.05).Conclusion The application of anterior zero notch interbody fusion appa⁃ratus and posterior microplate facilitates one-stage combined anterior and posterior cervical surgery for cervical spinal stenosis.It has improved surgical safety and can effectively avoid complications associated with traditional internal fixation,thus benefit⁃ing more patients.

关 键 词：颈椎管狭窄症 一期前后路联合手术 零切迹椎间融合器 后路单开门椎管减压 微型钢板 

分 类 号：R681.5[医药卫生—骨科学]