| 零切迹颈椎前路融合固定系统与传统融合器钢板内固定系统治疗单节段颈椎间盘突出症的病例对照研究 |
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Received:December 17, 2015
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| 作者 | Author | 单位 | Unit | E-Mail |
| 邵海宇 |
SHAO Hai-yu |
浙江省人民医院骨科脊柱外科中心, 浙江 杭州 310014 |
Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang, China |
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| 张骏 |
ZHANG Jun |
浙江省人民医院骨科脊柱外科中心, 浙江 杭州 310014 |
Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang, China |
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| 杨迪 |
YANG Di |
浙江省人民医院骨科脊柱外科中心, 浙江 杭州 310014 |
Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang, China |
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| 陈锦平 |
CHEN Jin-ping |
浙江省人民医院骨科脊柱外科中心, 浙江 杭州 310014 |
Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang, China |
spine_cjp@163.com |
| 黄亚增 |
HUANG Ya-zeng |
浙江省人民医院骨科脊柱外科中心, 浙江 杭州 310014 |
Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年29卷，第6期，第530-537页 |
| DOI：10.3969/j.issn.1003-0034.2016.06.011 |
| 基金项目:浙江省自然科学基金(编号:LY14H060006);浙江省医药卫生科学研究基金项目(编号:2015114820) |
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| 目的: 比较零切迹颈前路椎间融合固定系统(Zero-p)与传统钛板联合cage融合内固定术治疗单节段颈椎间盘突出症的临床疗效。方法: 对2011年8 月至2014 年3月接受颈前路椎间盘切除植骨融合内固定术的139例单节段颈椎间盘突出症患者的临床资料进行回顾性分析,根据已采取的不同术式分为A,B两组,其中A组63例,行前路椎间盘切除与Zero-P 融合内固定;B 组76例,行前路椎间盘切除椎间cage融合与钢板内固定。分别于手术前后对患者进行JOA评分、Odom功能评级;采用电视透视吞咽研究(videofluorographic swallowing study,VFSS)评估患者椎前软组织厚度;采用 Bazaz吞咽困难分级评估患者术后吞咽困难的发生率。术后12个月时采用颈椎正侧位X线及CT检查评估植骨融合情况,采用MRI检查评估临近节段退变情况。比较两组患者术中出血量、手术时间、手术前后JOA评分、Odom评级及VFSS中的椎前软组织厚度、术后患者吞咽困难发生率(Bazas评分)、椎体间融合率、邻近节段退变发生率。结果: 手术前后两组患者的JOA评分、Odom 功能评级差异比较无统计学意义(P>0.05);两组患者术前VFSS中的椎前软组织厚度比较差异无统计学意义(P>0.05);两组患者手术时间及术中出血量比较差异无统计学意义。两组患者VFSS中的椎前软组织厚度、吞咽困难发生率在术后第2天,术后3、6个月及末次随访时差异均有统计学意义(P<0.05).术后1年所有患者获植骨融合,两组融合率比较差异无统计学意义(P>0.05).A组8例(12.7%)出现邻近节段退变,B组19例(25%)出现临近节段退变,两组比较差异有统计学意义(P<0.05).结论: 应用零切迹颈椎前路椎间融合固定系统和传统钛板联合cage融合内固定治疗单节段颈椎间盘突出症均可取得满意疗效,前者术后吞咽困难和临近节段退变 发生率较低,中长期疗效有待进一步观察。 |
| [关键词]:颈椎病 椎间盘突出症 骨折固定术,内 病例对照研究 |
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| Case-control study on Zero-profile implant for anterior cervical discectomy and fusion and conventional cage plate internal fixation for the treatment of single segmental cervical intervertebral disc herniation |
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| Abstract:Objective: To compare clinical efficacy of Zero-profile implant for anterior cervical discectomy and fusion and conventional titanium plate with cage internal fixation for the treatment of single segmental cervical intervertebral disc herniation. Methods: From August 2011 to March 2014,clinical data of 139 patients with single cervical disc herniation treated with anterior cervical discectomy and interbody fusion with internal fixation were retrospectively analyzed. The patients were divided into two groups according to its operation method. There were 63 patients in group A which performed anterior discectomy and interbody fusion with Zero-profile;76 patients in group B which performed anterior cervical discectomy and cage plate internal fixation. JOA score and Odom functional rating between two groups were compared before and after operation. Videofluorographic swallowing study(VFSS) were used to evaluate thickness of prevertebral soft tissue. Bazaz dysphagia score were used to assess incidence of dysphagia. Postoperative AP X-ray and CT of cervical vertebra at 12 months were applied for evaluating bone graft fusion. Postoperative MRI was applied for evaluating the incidence of adjacent segment degeneration. Blood loss,operative time,preoperative and postoperative JOA score,Odom functional rating and VFSS score,Bazaz score,fusion rate between vertebral bodies and incidence of adjacent segment degeneration were compared between two groups.Results: There were no statistical meaning between two groups in JOA score,Odom functional rating before and after operation(P>0.05); and no significant meaning in VFSS score between two groups before operation(P>0.05); There were no significant difference in operative time and blood loss. There was statistical meaning in VFSS,Bazaz dysphagia score at 2 days,3 and 6 months after operation(P<0.05). All patients obtained bone union at 1 year after operation,and no obvious meaning in fusion rate(P>0.05). Eight patients (12.7%) in group A occurred adjacent segment degeneration and 19 patients(25%) in group B occurred adjacent segment degeneration,and there was significant meaning between two groups(P<0.05). Conclusion: Both of Zero-profile implant for anterior cervical discectomy and fusion and conventional cage internal fixation for the treatment of single segmental cervical intervertebral disc herniation could obtain satisfied clinical results. While Zero-profile implant for anterior cervical discectomy and fusion has advantages of lower incidence of adjacent segment degeneration,and its mid and long term following-up results still further observation. |
| KEYWORDS:Cervical spondylosis Intervertebral disk displacement Fracture fixation,internal Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邵海宇,张骏,杨迪,陈锦平,黄亚增.零切迹颈椎前路融合固定系统与传统融合器钢板内固定系统治疗单节段颈椎间盘突出症的病例对照研究[J].中国骨伤,2016,29(6):530~537 |
| 英文格式: | SHAO Hai-yu,ZHANG Jun,YANG Di,CHEN Jin-ping,HUANG Ya-zeng.Case-control study on Zero-profile implant for anterior cervical discectomy and fusion and conventional cage plate internal fixation for the treatment of single segmental cervical intervertebral disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(6):530~537 |
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