ZERO-P系统在颈椎前路手术中的应用效果分析  

Analysis of application effect of ZERO-P system in anterior cervical surgery

作　　者：马双[1] 张鑫博 彭翠云[1] 王耀生 冯克 闫仲峰 方剑 杜凯然 杜俊杰 MA Shuang;ZHANG Xinbo;PENG Cuiyun;WANG Yaosheng;FENG Ke;YAN Zhongfeng;FANG Jian;DU Kairan;DU Junjie(Department of Spinal Surgery,Yellow River Sanmenxia Hospital,Sanmenxia,Henan 472000,China;不详)

机构地区：[1]黄河三门峡医院脊柱外科,河南三门峡472000 [2]空军特色医学中心骨科,北京100080

出　　处：《中国骨与关节损伤杂志》2024年第5期449-453,共5页Chinese Journal of Bone and Joint Injury

基　　金：三门峡市科技发展计划项目(2020040350)。

摘　　要：目的观察Zero-P系统应用于颈前路手术的临床疗效,探讨其在治疗神经根型颈椎病中的优势。方法回顾性分析自2020-10—2022-12于黄河三门峡医院脊柱外科收治的58例神经根型颈椎病,根据手术方法不同进行分组,观察组28例采用颈椎前路Zero-P系统内固定,对照组30例采用钛板+融合器内固定。比较两组术中出血量、手术时间、住院时间,以及术后JOA评分、疼痛VAS评分、Odom评分情况、Cobb角、椎间隙高度、颈椎生理曲度、责任节段曲度。结果58例均获得随访,随访时间14~24个月,平均18.5个月。观察组术中出血量、手术时间、住院时间均少于对照组,差异有统计学意义(P<0.05)。两组末次随访JOA评分、疼痛VAS评分差异无统计学意义(P>0.05)。观察组术后Odom评分情况:优19例,良8例,可1例,优良率96.4%(27/28);对照组术后Odom评分:优13例,良11例,可6例,优良率80.0%(24/30)。观察组术后1例出现吞咽困难,对照组术后3例出现吞咽困难;观察组术后出现吞咽困难情况好于对照组,差异有统计学意义(P<0.05)。两组术后3个月、末次随访Cobb角以及椎间隙高度差异均无统计学意义(P>0.05)。两组术后3 d、术后1个月、术后3个月、末次随访颈椎生理曲度以及责任节段曲度差异均无统计学意义(P>0.05)。两组末次随访均无吞咽困难症状,观察组无内固定松动、移位,对照组1例出现融合器向后移位,但是根据颈椎CT+三维重建显示暂无需二次手术。结论采用颈椎前路Zero-P系统内固定治疗神经根型颈椎病疗效满意,具有手术时间短、术中出血量少、住院时间短的特点。Objective To observe the clinical effect of Zero-P system applied in anterior cervical surgery,and to investigate the advantages of ZERO-P system in the treatment of cervical radiculopathy.Methods A retrospective analysis was performed on 58 cases of cervical radiculopathy admitted to the spinal surgery department of Sanmenxia Hospital of the Yellow River from October 2020 to December 2022.The patients were grouped according to different surgical methods,28 cases in the observation group received anterior cervical Zero-P system internal fixation,and 30 cases in the control group received titanium plate+fusion device internal fixation.The amount of intraoperative blood loss,operation time,hospital stay,postoperative JOA score,pain VAS score,Odom score,Cobb Angle,vertebral space height,cervical physiological curvature and responsible segment curvature were compared between the two groups.Results All 58 cases were followed up for 14-24 months.The amount of blood loss,operation time and hospital stay in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in JOA score and pain VAS score at the last follow-up between the two groups(P>0.05).In the observation group,the Odom score was excellent in 19 cases,good in 8 cases and fair in 1 case,with an excellent and good rate of 96.4%(27/28).In the control group,the Odom score was excellent in 13cases,good in 11 cases and fair in 6 cases,with an excellent and good rate of 80.0%(24/30).Postoperative dysphagia occurred in 1 case in the observation group and 3 cases in the control group.Postoperative dysphagia in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in Cobb Angle and vertebral space height at 3 months and the last follow-up between the two groups(P>0.05).There were no significant differences in cervical physiological curvature and responsible segment c

关 键 词：神经根型颈椎病 零切迹椎间融合器 颈椎钛板融合器 颈椎前路减压融合术 吞咽困难 

分 类 号：R687.3[医药卫生—骨科学]