摘要
背景:颈前路椎间盘切除减压钢板固定融合治疗颈椎病的疗效确切,在提高椎间融合率的同时也存在一些诸如吞咽困难、邻近椎间盘退变等问题。一种新型的一体化颈前路椎间融合系统研制成功并投入临床使用。目的:探讨应用零切迹椎间融合固定系统治疗颈椎间盘突出症的早期疗效。方法:纳入2014年8月至2015年5月应用Peek Prevail椎间融合系统行颈椎前路椎间盘切除减压椎间融合内固定治疗颈椎间盘突出症的患者31例,均为单节段融合。采用目测类比评分、日本骨科学会评分、颈椎残障指数对患者术前术后情况进行评估;采用Bazaz吞咽困难评价标准评估术后患者吞咽困难发生情况;术前和术后1年应用MRI测量相邻椎间盘的信号强度和脊旁肌肉的型号强度,计算信噪比,评估术后终末随访时相邻节段椎间盘退变情况。术后定期复查颈椎X射线片,通过观察椎间隙高度、融合器有无松动下沉等评价临床早期疗效。结果与结论:(1)31例患者均获随访,随访时间为12-15个月;(2)手术时间平均(63.0±12.5)min,术中出血量平均(25.0±7.4)mL;3例患者术后2 d出现不同程度的吞咽不适,2例轻度,1例中度,对症处理后,2周内均完全消失;(3)所有患者术后临床症状与神经功能均得到改善。目测类比评分术前为(8.2±1.5)分,术后12个月下降到(2.4±1.2)分(P<0.05);日本骨科学会评分术前为(9.5±2.2)分,术后12个月时改善为(16.7±1.1)分(P<0.05);颈椎功能障碍指数术前为44.2±3.4,术后12个月时改善为11.3±1.0(P<0.05);相邻椎间盘术前信噪比为20.3±2.1,术后12个月信噪比为19.1±1.8,差异无显著性意义(P>0.05);(4)随访期间未发现融合器及螺钉松动、移位,融合器下沉等相关并发症;(5)结果表明,零切迹Peek Prevail椎间融合系统治疗颈椎间盘突出症固定融合稳定可靠,术后咽部不适的发生率低,短期内未加速相邻椎间盘的退变,近期临床�
BACKGROUND： Treatment outcomes of anterior cervical discectomy and fusion （ACDF） for cervical spondylosis are confirmed. The use of anterior plates increases fusion rates but may be associated with high rates of postoperative dysphagia and adjacent segment degeneration. A new Peek Prevail interbody device is designed to provide stability during spinal fusion. OBJECTIVE： To analyze the short-period clinical outcome of the Peek Prevail anterior cervical interbody fusion for cervical spondylosis. METHODS： From August 2014 to May 2015, 31 patients with cervical spondylosis implanted with Peek Prevail cervical interbody device in ACDF procedure were included. All patients underwent single-segmental fusion. The Visual Analogue Scale, Japanese Orthopaedic Association and neck disability index were assessed at baseline and postoperatively. The incidence of postoperative dysphagia was evaluated using Bazaz dysphagia index. The signal strength of the adjacent intervertebral disc and adjacent paraspinal muscle was measured on MRI, and signal-noise ratio was calculated to assess the degeneration of adjacent intervertebral disc at baseline and 1 year postoperatively. Cervical X-ray examination was regularly reviewed, the short-term efficacy was evaluated by observing the intervertebral space and cage loosening and subsidence. RESULTS AND CONCLUSION： （1） All 31 patients were followed up for 12-15 months. （2） The average operation time was （63.0±12.5） minutes and average intraoperative blood loss was （25.0＋7.4） mL. There were three （mild in two and medium in one patient） patients complaining of dysphagia at 2 days post-operation. All the symptoms of three cases disappeared after symptomatic treatment within 2 weeks. （3） All patients had a satisfactory improvement of neurologic outcome. The Visual Analogue Scale scores were decreased from 8.2±1.5 preoperatively to 2.4± 1.2 at 12 months postoperatively （P 〈 0.05）. The Japanese Orthopaedic Association scores at baseline and postoper
作者
李果
何跃
顾祖超
张宇
刘进
Li Guo;He Yue;Gu Zu-chao;Zhang Yu;Liu Jin(Department of Spine Surgery,Chengdu First People’s Hospital,Chengdu 610041,Sichuan Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第27期4348-4353,共6页
Chinese Journal of Tissue Engineering Research
关键词
零切迹椎间融合
颈椎间盘突出症
早期疗效
Spinal Fusion
Intervertebral Disk Displacement
Tissue Engineering
