两种零切迹椎间融合器治疗单节段脊髓型颈椎病的疗效比较  

Comparison of the Efficacy of Two Zero-Notch Interbody Fusion Devices on the Treatment of Single-Level Cervical Spondylotic Myelopathy

作　　者：张翔 汤国庆[1,2] 陈勇 ZHANG Xiang;TANG Guoqing;CHEN Yong(Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300,Jiangsu China;Kunshan Branch of Jiangsu Clinical Research Institute of Traditional Chinese Medicine,Kunshan 215300,Jiangsu China)

机构地区：[1]昆山市中医医院,江苏昆山215300 [2]江苏省中医临床研究院昆山分院

出　　处：《中国中医骨伤科杂志》2024年第8期48-54,共7页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家自然科学基金青年基金项目(81802180);苏州市医疗卫生科技创新医学创新应用研究项目(SKYD2022052);昆山市社会发展科技项目(KSF202141)。

摘　　要：目的:比较双插片自稳型椎间融合器(ROI-C)和双向螺钉零切迹椎间融合器(Zero-P)在颈椎前路减压融合内固定术(ACDF)中应用的临床效果。方法:对2018年1月至2023年1月收治的65例单节段脊髓型颈椎病患者行颈椎前路减压融合内固定术治疗进行回顾性分析,其中采用ROI-C治疗组35例,采用Zero-P治疗组30例。比较两组患者出血量、手术时间,术前及术后视觉模拟量表(VAS)评分、日本骨科协会(JOA)评分、颈椎功能障碍指数(NDI)评分,评估术后吞咽困难情况及椎体融合情况。结果:对于接受单节段颈椎前路减压融合内固定术的65例患者,均进行完整随访1年。对比研究发现在手术时间方面,C3/4及C6/7节段间隙两组对比,ROI-C组手术时间短于Zero-P组,差异有统计学意义(P<0.05),其余节段手术时间无明显差异。术后两组患者VAS评分和JOA评分均较术前明显改善,两组间差异无统计学意义(P>0.05)。ROI-C组术后吞咽困难发生率为1/35,Zero-P组为1/30,两组间差异无统计学意义(P>0.05)。末次随访时,根据Bridwell融合评价标准,ROI-C组和Zero-P组患者颈椎目标间隙均融合。结论:两种零切迹椎间融合器治疗单节段脊髓型颈椎病均具有安全性高、临床效果良好、手术操作简单、出血量少、术后吞咽困难发生率低等优势,对于高位或低位椎间隙,ROI-C组优势更明显。Objective:To compare the clinical efficacy of double-insert self-stable interbody fusion cage(ROI-C)and bidirectional zero-profile interbody fusion cage(Zero-P)in anterior cervical decompression and internal fixation(ACDF).Methods:From January 2018to January 2023,65patients with single-level cervical spondylotic myelopathy underwent ACDF surgery were retrospectively analyzed.The ROI-C treatment group 35cases,the Zero-P treatment group 30cases.The blood loss,operation time,preoperative and postoperative visual analogue scale(VAS),Japanese Orthopaedic Association(JOA)and neck disability index(NDI)scores were compared between the two groups.Assessment of postoperative dysphagia and assess vertebral fusion.Results:For single segment ACDF surgery,65 patients were performed complete follow-up of 1year.The comparative study found that the operation time of ROI-C group was significantly shorter than that of Zero-P group at C3/4and C6/7segments(P<0.05),and there was no significant difference in the operation time of other segments.Two groups of patients with postoperative VAS scores,JOA scores were obviously improved compared with preoperative,there was no statisti-cally significant difference between the two groups(P>0.05).ROI-C group,the incidence of postoperatie dysphagia at 1/35,Zero-P group is 1/30,there was no statistically significant difference between the two groups.At last follow-up,according to Bridwell fusion evaluation criteria,the target space of cervical spine in ROI-C group and Zero-P group fused.Conclusion:The two zero-profile interbody fusion cages in the treatment of single-level cervical spondylotic myelopathy have the advantages of high safety,good clinical efficacy,simple operation,less bleeding,and low incidence of postoperative dysphagia.For high or low intervertebral space,the advantages of ROI-C group are more obvious.

关 键 词：脊髓型颈椎病 颈椎前路减压融合内固定术 颈椎融合 

分 类 号：R681.5[医药卫生—骨科学]