摘要
目的比较零切迹融合器(ROI-C)与钉板融合器内固定系统治疗单节段脊髓型颈椎病(CSM)的效果,探讨ROI-C应用的有效性和安全性。方法选取2017-06—2018-06间在郑州大学第一附属医院接受颈前路减压植骨融合术(ACDF)治疗的109例单节段CSM患者,随机分为2组。A组54例采用ROI-C行融合术,B组55例采用传统钉板融合器内固定术。比较2组手术时间、术中出血量、日本骨科协会(JOA)评分、手术节段融合率及术后并发症情况。结果A组手术时间、术中出血量均短于或低于B组,差异有统计学意义(P<0.05)。2组术后3个月、6个月及末次随访时JOA评分、颈椎Cobb角均较术前有明显改善,差异有统计学意义(P<0.05)。2组术后各时间点JOA评分比较差异均无统计学意义(P>0.05)。术后3个月,2组手术节段融合率比较,差异无统计学意义(P>0.05)。末次随访时,2组手术节段均获骨性融合。术后1个月、3个月随访时,A组吞咽困难发生率均低于B组,差异有统计学意义(P<0.05)。末次随访时,2组吞咽困难发生率差异无统计学意义(P>0.05)。随访期间2组均未出现内植物移位、断裂、神经症状加重、邻近节段严重退变等并发症。结论ROI-C与传统钢钉板融合器内固定术应用于ACDF在治疗单节段CSM时均疗效可靠,但ROI-C手术时间短、术中出血少、软组织损伤小、术后吞咽困难发生率低。
Objective To compare the clinical efficacy of zero notch fusion cage(ROI-C)and nail plate fusion cage internal fixation system in the treatment of single segment cervical Spondylotic myelopathy(CSM),and to explore the effectiveness and safety of ROI-C.Methods Totally 109 patients with single segment CSM treated by anterior cervical decompression and bone grafting fusion(ACDF)were randomly divided into two groups.Group A(54 cases)was treated with ROI-C fusion,and group B(55 cases)was treated with traditional nailboard fusion cage internal fixation.The operation time,intraoperative bleeding,(JOA)score,fusion rate and postoperative complications were compared between the two groups.Results The operation time and intraoperative blood loss in group A were shorter than or lower than those of group B,the difference was statistically significant(P<0.05).The JOA score and cervical Cobb angle of cervical vertebrae in group A were significantly improved at 3 and 6 months after operation and at the last follow-up,but there was no significant difference in JOA score between the two groups at each time point after operation(P>0.05).At 3 months after operation,there was no significant difference in the fusion rate between the two groups(P>0.05),and the bone fusion was obtained in both groups at the last follow-up.Incidence of dysphagia in group A at 1 and 3 months after operation was lower than that of group B(P<0.05),but there was no significant difference in the incidence of dysphagia between the two groups at the last follow-up(P>0.05).During the follow-up period,there were no complications such as internal plant displacement,rupture,aggravation of neurological symptoms and severe degeneration of adjacent segments.Conclusion ROI-C and traditional steel nail plate fusion cage internal fixation are reliable in the treatment of single segment CSM,but the operation time of ROI-C is short,the bleeding during operation is less,the soft tissue injury is small,and the incidence of dysphagia after operation is low.
作者
刘屹林
杨浩
王玉强
赵耀
张书豪
王利民
Liu Yilin;Yang Hao;Wang Yuqiang;Zhao Yao;Zhang Shuhao;Wang Limin(The first affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China)
出处
《河南外科学杂志》
2019年第4期22-24,共3页
Henan Journal of Surgery
