| 颈前路零切迹融合系统和传统钉板系统治疗脊髓型颈椎病的临床比较 |
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投稿时间：2016-01-11
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| 作者 | Author | 单位 | Address | E-Mail |
| 常步青 |
CHANG Bu-qing |
徐州医科大学附属医院, 江苏 徐州 221000 |
Department of Orthopaedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 冯虎 |
FENG Hu |
徐州医科大学附属医院, 江苏 徐州 221000 |
Department of Orthopaedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
xzfeng_hu@126.com |
| 于朝将 |
YU Chao-jiang |
徐州医科大学附属医院, 江苏 徐州 221000 |
Department of Orthopaedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 黄凯 |
HUANG Kai |
徐州医科大学附属医院, 江苏 徐州 221000 |
Department of Orthopaedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 高啸 |
GAO Xiao |
徐州医科大学附属医院, 江苏 徐州 221000 |
Department of Orthopaedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 唐浩 |
TANG Hao |
徐州医科大学附属医院, 江苏 徐州 221000 |
Department of Orthopaedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 蒋允昌 |
JIANG Yun-chang |
徐州医科大学附属医院, 江苏 徐州 221000 |
Department of Orthopaedics, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China |
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| 期刊信息：《中国骨伤》2017年，第30卷，第5期，第411-416页 |
| DOI：10.3969/j.issn.1003-0034.2017.05.007 |
| 基金项目: |
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中文摘要:
目的：比较颈椎前路减压融合术（anterior cervical discectomy and fusion，ACDF）中传统钉板系统与颈前路零切迹融合器（Zero-P）治疗脊髓型颈椎病（cervical spondylotic myelopathy，CSM）的短期疗效。
方法：对2014年7月至2015年8月收治的45例CSM患者的临床资料进行回顾性分析，男23例，女22例；年龄32～71岁，平均53.7岁；病程5个月～2年。其中24例采用传统钉板系统固定（传统钉板组），21例采用Zero-P系统固定（Zero-P组）.采用日本骨科协会评分（Japanese Orthopaedic Association scores，JOA）评价患者术前、术后1周及末次随访时神经功能恢复的情况，视觉模拟评分法（visual analogue scale，VAS）评估患者手术前后颈部疼痛情况；通过 X 线或 CT 观察术前术后颈椎生理曲度（C2-C7的 Cobb 角）恢复情况、椎间融合情况，并记录手术时间、术中出血量，探讨术后吞咽困发生程度及其发生率。
结果：45 例患者均获得随访，随访时间12～16个月，平均14 个月。传统钉板组和Zero-P组的手术时间分别为（87.6±23.2）min和（62.7±17.3）min，差异有统计学意义；出血量分别为（80.2±36.8）ml 和（78.4±29.6）ml，差异无统计学意义。末次随访两组JOA、VAS评分均较术前明显改善，但两组比较差异无统计学意义。传统钉板组和Zero-P组Cobb 角术前分别为（8.7±4.3）°、（8.6±4.2）°，差异无统计学意义；末次随访分别为（14.5±6.4）°、（17.4±8.6）°，差异有统计学意义。吞咽困难发生率传统钉板组为29.17%，Zero-P组为9.52%，差异有统计学意义。末次随访时手术节段椎间隙全部融合。未见气管食管损伤及喉返神经损伤等并发症发生。未发现融合器移位、沉降、松动、断裂等情况。
结论：Zero-P与传统钉板系统在治疗脊髓型颈椎病中均能提供即刻稳定性、可靠地融合性等获得满意的治疗效果，但Zero-P可以缩短手术时间，更好的恢复颈椎生理曲度，减少术后吞咽困难发生率。 |
| 【关键词】颈椎病 零切迹 脊柱融合 减压，外科 |
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| Comparison of clinical effects between anterior cervical Zero-incision fusion system and traditional nail plate system in the treatment of cervical spondylotic myelopathy |
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ABSTRACT
Objective: To compare the short-term efficacy of anterior cervical discectomy and fusion(ACDF) with traditional nail plate system and Zero-profile device in the treatment of cervical spondylotic myelopathy(CSM).
Methods: The clinical data of 45 patients with CSM treated from July 2014 to August 2015 was retrospectively analyzed. There were 23 males and 22 females with an average age of 53.7 years old(range,32 to 71 years old). The course of disease was 5 months to 2 years. All the patients were treated with ACDF with 24 cases by traditional nail plate system fixation(group A) and 21 cases by Zero-P system fixation(group B). Operation time and intraoperative bleeding were compared between two groups. Neurological function and cervical pain were evaluated by Japanese Orthopaedic Association scores (JOA) and visual analogue scale (VAS),respectively. Cervical curvature(Cobb angle) change and intervertebral fusion were evaluated by X-rays and CT. And associated complications were analyzed in two groups.
Results: All the patients were followed up for 12 to 16 months with an average of 14 months. Operation time of group A and B was(87.6±23.2) min and (62.7±17.3) min respectively,and the difference was significant between two groups;and intraoperative bleeding was (80.2±36.8) ml and (78.4±29.6) ml respectively,and the difference was not significant. At final follow-up,JOA and VAS of all patients were obvious improved,but there was no significant difference between two groups. Preoperative Cobb angle in group A and B was (8.7±4.3)° and (8.6±4.2)° respectively,and the difference was significant. The Cobb angle at final follow-up was (14.5±6.4)° and (17.4±8.6)° respectively,and the difference between two groups was significant. The incidence of dysphagia in group A and B were 29.17% and 9.52% respectively,and there was significant difference between two groups. All intervertebral spaces got fusion at final follow-up. No tracheo-a sophageal injury and recurrent laryngeal nerve damage or other complications were found. No fusional migration,subsidence,loosening,breakage,etc. were found.
Conclusion: The clinical comparison of Zero-P interbody fixation system and cervical plate internal fixation for the treatment of cervical spondylosis was quite fair,but Zero-P showed a better therapeutic effect with improvement of life quality. |
| KEY WORDS Cervical spondylosis Zero-profile device Spinal fusion Decompression,surgical |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 常步青,冯虎,于朝将,黄凯,高啸,唐浩,蒋允昌.颈前路零切迹融合系统和传统钉板系统治疗脊髓型颈椎病的临床比较[J].中国骨伤,2017,30(5):411~416 |
| 英文格式: | CHANG Bu-qing,FENG Hu,YU Chao-jiang,HUANG Kai,GAO Xiao,TANG Hao,JIANG Yun-chang.Comparison of clinical effects between anterior cervical Zero-incision fusion system and traditional nail plate system in the treatment of cervical spondylotic myelopathy[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(5):411~416 |
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