| 零切迹融合器联合钛板椎间融合器治疗多节段脊髓型颈椎病 |
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投稿时间：2023-08-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 钟建斌 |
ZHONG Jian-bin |
宁波市第六医院脊柱外科, 浙江 宁波 315040 |
Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China |
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| 胡勇 |
HU Yong |
宁波市第六医院脊柱外科, 浙江 宁波 315040 |
Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China |
huyong610@163.com |
| 储振涛 |
CHU Zhen-tao |
宁波大学医学院, 浙江 宁波 315211 |
Medical School of Ningbo University, Ningbo 315211, Zhejiang, China |
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| 董伟鑫 |
DONG Wei-xin |
宁波市第六医院脊柱外科, 浙江 宁波 315040 |
Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China |
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| 袁振山 |
YUAN Zhen-shan |
宁波市第六医院脊柱外科, 浙江 宁波 315040 |
Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China |
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| 孙肖阳 |
SUN Xiao-yang |
宁波市第六医院脊柱外科, 浙江 宁波 315040 |
Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China |
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| 朱秉科 |
ZHU Bing-ke |
宁波市第六医院脊柱外科, 浙江 宁波 315040 |
Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China |
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| 赖欧杰 |
LAI Ou-jie |
宁波市第六医院脊柱外科, 浙江 宁波 315040 |
Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第12期，第1188-1195页 |
| DOI：10.12200/j.issn.1003-0034.20230328 |
| 基金项目:浙江省医药卫生科技计划项目(编号:2021KY327,2023KY1147);宁波市重点研发计划暨揭榜挂帅项目(编号:2023Z198);宁波市鄞州区农业与社会发展计划项目(编号:2023AS058) |
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中文摘要:
目的: 探讨零切迹融合器联合钛板椎间融合器治疗多节段脊髓型颈椎病的临床疗效。
方法: 回顾性分析2016年1月至2020年1月手术治疗的107例多节段脊髓型颈椎病患者,根据手术方式不同分为Hybrid组和对照组。Hybrid组54例,男42例,女12例;年龄33~77(57.3±9.5)岁;C3-C6 20例,C4-C7 27例,C3-C7 7例;采用零切迹融合器联合钛板椎间融合器内固定术。对照组53例,男34例,女19例;年龄36~79(57.8±8.9)岁;C3-C6 17例,C4-C7 27例,C3-C7 9例,采用钛板椎间融合器内固定术。比较两组手术时间、术中出血量和并发症情况,采用视觉模拟评分(visual analogue scale,VAS)、日本骨科学会(Japanese Orthopedic Association,JOA)评分和颈椎功能障碍指数(neck disability index,NDI)评估临床症状恢复情况;测量并比较颈椎前凸角(cervical lordosis,CL)、颈椎矢状垂直轴(cervical sagittal vertical axis,C-SVA)和T1倾角(T1 slope,T1S)以评估颈椎矢状面参数。
结果: 107例患者均获得随访,Hybrid组随访时间为24~64(31.7±18.4)个月,对照组随访时间为24~65(32.6±15.8)个月,两组随访时间比较,差异无统计学意义(P>0.05)。Hybrid组手术时间和出血量少于对照组(P<0.05)。两组末次随访颈部VAS、JOA评分和NDI均较术前明显改善(P<0.05)。两组手术前后颈部VAS、JOA和NDI评分组间比较,差异无统计学意义(P>0.05)。两组术后3个月及末次随访CL均较术前明显改善(P<0.05),两组手术前后T1S和C-SVA组间比较,差异无统计学意义(P>0.05)。Hybrid组术后2例出现吞咽困难,对照组9例出现吞咽困难,两组比较差异有统计学意义(χ2=5.112,P=0.024)。随访期间两组无内固定物松动、移位、断裂等并发症。
结论: 与钛板椎间融合器相比,零切迹融合器联合钛板椎间融合器治疗多节段脊髓型颈椎病可缩短手术时间和出血量,减少手术创伤及术后吞咽困难,有利于早期快速康复。 |
| 【关键词】多节段脊髓型颈椎病 外科手术 零切迹融合器 颈前路间盘切除植骨融合术 |
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| Zero-profile intervertebral fusion with cage-titanium plate for the treatment of multilevel cervical spondylotic myelopathy |
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ABSTRACT
Objective To explore clinical effect of Zero-profile intervertebral fusion with cage-titanium plate in treating multilevel cervical spondylotic myelopathy.
Methods From January 2016 to January 2020,107 patients with multisegmental cervical spondylotic myelopathy treated by surgery were retrospectively analyzed and divided into Hybrid group and control group according to different surgical methods. There were 54 patients in Hybrid group,including 42 males and 12 females,aged from 33 to 77 years old with an average of (57.3±9.5) years old;20 patients with C3-C6,27 patients with C4-C7 and 7 patients with C3-C7;Zero-profile intervertebral fusion with cage-titanium plate internal fixation was performed. There were 53 patients in control group,including 34 males and 19 females;aged from 36 to 79 years old with an average of (57.8±8.9) years old;17 patients with C3-C6,27 patients with C4-C7,and 9 patients with C3-C7;titanium plate interbody fusion fixation was performed. Operation time,blood loss and complications between two groups were compared,visual analogue scale (VAS),Japanese Orthopedic Association (JOA) scores and neck disability index (NDI) were used to assess recovery of clinical symptoms;cervical lordosis (CL),cervical sagittal vertical axis (C-SVA),and T1 slope (T1S) were measured and compared to evaluate cervical sagittal plane parameters.
Results All patients were followed up,Hybrid group was followed up for 24 to 64 months with an average of (31.7±18.4) months,and control group was followed up for 24 to 65 months with an average of (32.6±15.8) months. There was no significant difference in follow-up time between two groups (P>0.05). Operation time and blood loss in Hybrid group were less than those in control group (P<0.05). VAS,JOA score and NDI were significantly improved between two groups at the lastest follow-up (P<0.05). There were no significant difference in VAS,JOA and NDI scores between two groups before and after operation (P>0.05). CL in both two groups at 3 months and the latest follow-up after operation were significantly improved than those before operation (P<0.05),there were no significant difference between two groups in T1S and C-SVA before and after operation (P>0.05). Postoperative dysphagia occurred in 2 patients in Hybrid group and 9 patients in control group,and had statistically difference in the incidence of dysphagia between two groups (χ2=5.112,P=0.024). During the follow-up,there were no complications such as loosening,displacement or fracture of internal fixation between two groups.
Conclusion Compared with titanium plate interbody fusion,Zero-profile intervertebral fusion combined with cage-titanium plate for the treatment of multilevel cervical spondylotic myelopathy could shorten surgical time and blood loss,reduce surgical trauma and postoperative swallowing difficulties,and is conducive to early and rapid recovery. |
| KEY WORDS Multilevel cervical spondylotic myelopathy Surgical procedure Zero-profile intervertebral fusion Anterior cervical discectomy and fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 钟建斌,胡勇,储振涛,董伟鑫,袁振山,孙肖阳,朱秉科,赖欧杰.零切迹融合器联合钛板椎间融合器治疗多节段脊髓型颈椎病[J].中国骨伤,2024,37(12):1188~1195 |
| 英文格式: | ZHONG Jian-bin,HU Yong,CHU Zhen-tao,DONG Wei-xin,YUAN Zhen-shan,SUN Xiao-yang,ZHU Bing-ke,LAI Ou-jie.Zero-profile intervertebral fusion with cage-titanium plate for the treatment of multilevel cervical spondylotic myelopathy[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(12):1188~1195 |
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