摘要
目的探讨应用ROI-C融合器行颈椎前路椎间盘切除椎间植骨融合术(anterior cervical discetomy and fusion, ACDF)治疗单节段颈椎病的临床疗效及安全性。方法单节段颈椎病患者123例,应用ROI-C融合器行ACDF治疗56例为观察组,应用颈前路钉板系统行ACDF治疗者67例为对照组。记录2组手术时间、出血量及吞咽困难发生情况;记录手术前及术后3个月患者视觉模拟评分(visual analogue scale, VAS)、颈椎功能障碍指数(neck disability index, NDI)和改良日本骨科协会评分(modified Japanese Orthopedic Association Scale, mJOA)以及颈椎前凸度、椎间高度;随访观察有无远期并发症及植骨融合情况。结果观察组手术时间[(76.96±8.98)min]短于对照组[(82.31±7.57)min](P<0.05),术中出血量[(51.64±20.35)mL]少于对照组[(57.97±17.90)mL](P<0.05),术后吞咽困难发生率(35.7%)低于对照组(58.2%)(P<0.05),中位吞咽困难持续时间(13.5 d)短于对照组(18.0 d)(P<0.05)。术后3个月,观察组和对照组VAS评分[(1.56±0.98)、(1.59±1.02)分]、NDI评分[(13.57±2.85)、(14.11±3.25)分]均较术前[VAS评分(6.12±2.15)、(5.90±1.92)分,NDI评分(35.73±2.81)、(36.21±3.74)分]降低(P<0.05),mJOA评分[(13.89±2.56)、(13.80±3.15)分]较术前[(11.43±2.10)、(11.66±1.92)分]提高(P<0.05);观察组和对照组颈椎前凸度[(15.75±4.21)°、(13.85±3.13)°]、椎间高度[(6.30±1.05)、(5.97±0.97)mm]均较术前[(10.42±6.74)°、(10.99±5.81)°,(4.86±1.18)、(4.69±1.02)mm]增加(P<0.05),且观察组大于对照组(P<0.05)。随访(21.46±4.51)个月,观察组邻椎退行性变发病率(8.9%)低于对照组(23.9%)(P<0.05),术后3个月时观察组植骨融合率(64.3%)高于对照组(46.3%)(P<0.05),末次随访时2组椎间植骨均达到骨性融合。结论应用ROI-C融合器行ACDF治疗单节段颈椎病可达到与应用颈前路钉板系统行ACDF同样的临床疗效和更好的影像学结果,可减少手术时间和术中出血量,降低术后吞咽困难、�
Objective To explore the clinical outcome and safety of anterior cervical discetomy and fusion(ACDF) by using ROI-C cage in the treatment of single-segment cervical spondylosis. Methods Totally 123 patients with single-segment cervical spondylosis were divided into 56 patients undergoing ACDF with ROI-C cage(observation group) and 67 patients undergoing ACDF with plate-screw-cage system(control group). The operation lasting time, intraoperative blood loss and dysphagia were recorded. The scores of visual analogue scale(VAS), neck disability index(NDI), modified Japanese Orthopedic Association Scale(mJOA), cervical lordosis and intravertebral height were recorded before and 3 months after operation. All patients were followed-up to observe long-term complication and bone fusion. Results Observation group had shorter operation lasting time((76.96±8.98) min), less intraoperative blood loss((51.64±20.35) mL), lower incidence of dysphagia(35.7%) and shorter duration of dysphagia(13.5 d) than control group((82.31±7.57) min,(57.97±17.90) mL, 58.2%, 18.0 d)(P<0.05). The VAS scores(1.56±0.98, 1.59±1.02) and NDI scores(13.57±2.85, 14.11±3.25) were lower 3 months after operation than those before operation(VAS: 6.12±2.15, 5.90±1.92;NDI: 35.73±2.81, 36.21±3.74) in observation group and control group(P<0.05), while mJOA scores were higher 3 months after operation(13.89±2.56, 13.80±3.15) than those before operation(11.43±2.10, 11.66±1.92) in observation group and control group(P<0.05). Postoperative cervical lordosis((15.75±4.21)°,(13.85±3.13)°) and intravertebral height((6.30±1.05),(5.97±0.97) mm) were larger than those before operation((10.42±6.74)°,(10.99±5.81)°;(4.86±1.18),(4.69±1.02)mm)in observation group and control group(P<0.05),and were larger in observation group than those in control group(P<0.05).The follow-up survey lasted for(21.46±4.51)months,showing a lower rate of adjacent segmental degeneration in observation group(8.9%)than that in control group(23.9%)(P<0.05).The bone fusion rat
作者
张怀栓
张猛
潘玉林
杨广辉
郭小伟
王祥善
李保田
熊森
郭亮兵
郭营
ZHANG Huaishuan;ZHANG Meng;PAN Yulin;YANG Guanghui;GUO Xiaowei;WANG Xiangshan;LI Baotian;XIONG Sen;GUO Liangbing;GUO Ying(Department of Spinal Surgery,Zhengzhou Orthopaedics Hospital,Zhengzhou 450052,China)
出处
《中华实用诊断与治疗杂志》
2020年第10期1036-1039,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划(2018020707)。
