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何阿祥,谢栋,杨立利,陈雄生,贾连顺.Zero-P用于三节段颈椎前路融合术的中期疗效[J].脊柱外科杂志,2017,15(3):129-133.
Zero-P用于三节段颈椎前路融合术的中期疗效     点此下载全文 (Fulltext)
何阿祥  谢栋  杨立利  陈雄生  贾连顺
第二军医大学附属长征医院骨科, 上海 200003
基金项目:国家自然科学基金(81572194,81371383);上海市西医引导类项目(16411963900)
DOI:10.3969/j.issn.1672-2957.2017.03.001
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摘要:
      目的 通过与传统融合器并钛板融合术比较,探索C4/C5/C6/C7三节段Zero-P融合治疗颈椎退变性疾病的中期临床疗效与影像学变化。方法 纳入2009年7月-2013年5月在本院接受C4/C5/C6/C7颈椎融合手术的患者共72例。其中A组患者应用Zero-P进行融合,共30例;B组用传统融合器加钛板,共42例。两组患者术前各项参数比较差异无统计学意义。于术后2个月、6个月、1年、2年及近期各时间点进行复查随访,比较两组患者日本骨科学会(JOA)评分、颈椎功能障碍指数(NDI)、颈椎曲度、C4~7 Cobb角、吞咽困难发生率、融合率、邻近节段退变(ASD)发生率等的差异。结果 所有患者随访>2年,随访期间,A组与B组术后JOA评分、NDI、融合率及ASD发生率比较差异均无统计学意义。A组患者术后C4~7 Cobb角呈缓慢丢失趋势,在术后2年及末次随访时小于B组(P<0.05)。A组患者术后颈椎曲度呈缓慢丢失趋势,在末次随访时低于B组(P<0.05)。A组患者吞咽困难发生率于术后2个月时低于B组(P<0.05),余随访时间两组差异无统计学意义。结论 Zero-P用于颈椎三节段融合时中期疗效满意、并发症少。其可有效降低术后2个月吞咽困难发生率,但对手术节段Cobb角及颈椎曲度的维持作用较差。
关键词:颈椎  颈椎病  椎间盘切除术  脊柱融合术  内固定器
Anterior cervical interbody fusion with the Zero-P spacer: mid-term results of 3-level fusion    Fulltext
HE A-xiang  XIE Dong  YANG Li-li  CHEN Xiong-sheng  JIA Lian-shun
Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
Fund Project:
Abstract:
      Objective To explore the mid-term surgical outcomes and radiographic changes of C4/C5/C6/C7 3-level fusion with Zero-P spacer in the treatment of cervical degenerative disease through compared with traditional cage with titanium plate.Methods Totally 72 C4/C5/C6/C7 cervical fusion patients from July 2009 to May 2013 were included in this study, with 30 patients in group A using Zero-P for fusion, while 42 patients in group B using traditional cage and titanium plate.There was no significant difference in patient's preoperative parameters between 2 groups.The Japanese Orthopedic Association (JOA) score, neck disability index (NDI), cervical curvature, C4-7 Cobb's angle, incidence of dysphagia, fusion rate, adjacent segment degeneration rate were compared between 2 groups at 2 months, 6 months, 1 year, 2 years after operation and the final follow-up.Results The JOA score, NDI, fusion rate and adjacent segment degeneration rate showed no statistically significant difference between 2 groups at all observation time points.The C4-7 Cobb's angle of group A showed slowly lost trend, and significantly lower than that of group B at postoperative 2 years and final follow-up (P<0.05).The cervical curvature in group A also showed slowly lost trend, and significantly lower than that of group B only at final follow-up (P<0.05).The incidence of dysphagia in group A was significantly lower than that of group B (P<0.05) at postoperative 2 months, but had no significant difference at other follow-up time point.Conclusion Zero-P has a satisfactory mid-term outcomes with fewer complications when it is used in 3-level anterior cervical discectomy and fusion.It can effectively reduce the incidence of dysphagia at 2 months after operation, but it is poor in the maintenance of operated segment Cobb's angle and cervical curvature.
Keywords:Cervical vertebrae  Cervical spondylosis  Diskectomy  Spinal fusion  Internal fixators
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