单节段颈椎减压融合个性化与成品零切迹融合器比较  

Personalized zero profile devices versus finished counterpart for single-level anterior cervical decompression and fusion

作　　者：刘启彬 吴亚伟 龙科含 李润泽 张磊[1] 张晶涛 LIU Qi-bin;WU Ya-wei;LONG Ke-han;LI Run-ze;ZHANG Lei;ZHANG Jing-tao(Department of Orthopedic Surgery,The First AffiliatedHospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Jinan,Shandong 250013,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)骨外科,山东济南250013

出　　处：《中国矫形外科杂志》2025年第2期124-130,共7页Orthopedic Journal of China

摘　　要：[目的]探讨颈椎前路椎间盘切除融合(anterior cervical discectomy and fusion,ACDF)联合3D打印零切迹融合器(Cage)治疗单节段颈椎病的临床效果。[方法]回顾性分析本院2019年1月—2022年9月收治的46例需行ACDF患者的临床资料,根据医患沟通结果,12例采用3D打印零切迹Cage(个性化组),34例采用聚醚醚酮(poly-ether-etherke-tone,PEEK)零切迹Cage(成品组),比较两组围手术期、随访及影像资料。[结果]两组手术时间、切口总长度、术中失血量、透视次数、下地行走时间、住院时间的差异均无统计学意义(P>0.05)。个性化组Cage置入时间[(8.6±0.8)min vs(9.4±0.9)min,P=0.007]显著少于成品组。随访平均时间(34.1±13.2)个月,两组完全负重活动时间的差异无统计学意义(P>0.05)。术后随时间推移,两组NDI评分、JOA评分、锥体束征均显著改善(P<0.05)。术后6个月,个性化组JOA评分[(16.4±0.8)vs(15.9±0.7),P=0.034]显著优于成品组;末次随访时,个性化组NDI评分[(0.8±2.0)vs(1.3±1.4),P=0.027]和JOA评分[(16.7±0.7)vs(16.0±0.8),P=0.008]均显著优于成品组。影像方面,末次随访时,个性化组椎间高度[(8.4±0.7)mm vs(7.4±0.8)mm,P<0.001]显著优于成品组,相应时间点,两组颈椎前凸角、椎管矢状径、Bridwell评级差异均无统计学意义(P>0.05)。[结论]对于行ACDF治疗单节段的颈椎病患者,3D打印零切迹Cage置入时间更短、融合质量更好、能更好地维持椎间高度、更有效地缓解术前症状,早期临床疗效更好。[Objective]To compare the clinical outcomes of anterior cervical discectomy and fusion(ACDF)with personalized(3Dprinted)zero profile fusion device(the PZPD)versus the finished zero profile fusion device(the FZPD)in the treatment of single-level cer-vical myelopathy.[Methods]A retrospective study was conducted on 46 patients who underwent ACDF for single-level cervical myelopa-thy in our hospital from January 2019 to September 2022.According to doctor-patient communication,12 patients had ACDF performedwith the PZPD,while other 34 patients were treated with poly-ether-etherke-tone(PEEK)FZPD.The data of the perioperative period,fol-low-up and images were compared between the two groups.[Results]There were no significant differences in operation time,total incisionlength,intraoperative blood loss,fluoroscopy times,ambulation time and hospital stay between the two groups(P>0.05),but the PZPDgroup consumed significantly less device placement time than the FZPD group[(8.6±0.8)min vs(9.4±0.9)min,P=0.007].The mean followuptime was(34.1±13.2)months,and there was no significant difference in time to return full weight-bearing activity between the twogroups(P>0.05).The NDI and JOA scores,as well as pyramidal tract sign were significantly improved in both groups over time postopera-tively(P<0.05).The PZPD group proved significantly superior to the FZPD group in terms of JOA score[(16.4±0.8)vs(15.9±0.7),P=0.034]6 months postoperativwly,JOA score[(16.7±0.7)vs(16.0±0.8),P=0.008]and NDI score[(0.8±2.0)vs(1.3±1.4),P=0.027]at the latest fol-low-up.Radiographically,the PZPD group had significantly greater intervertebral height than the FZPD group at the last follow-up[(8.4±0.7)mm vs(7.4±0.8)mm,P<0.001],although there were no statistically significant differences in cervical lordosis angle,spinal canal sagit-tal diameter and Bridwell fusion grade between the two groups at any corresponding time points(P>0.05).[Conclusion]The personalizedzero profile fusion device has advantages of quick device placement,better interverteb

关 键 词：单节段颈椎病 颈前路椎间盘切除融合 零切迹融合器 3D打印 治疗结果 

分 类 号：R681.55[医药卫生—骨科学]