自锁式零切迹颈椎融合器治疗颈椎病的疗效观察
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摘要
目的:探讨自锁式零切迹颈椎融合器治疗颈椎病的临床疗效。方法:回顾性分析颈椎病行手术治疗病人30例的临床资料,根据病人手术方式的不同分为自锁式零切迹颈椎融合器组(观察组)和椎体次全切+植骨融合颈椎钢板内固定组(对照组),各15例。比较2组病人临床疗效。结果:观察组手术时间、术中出血量和术后引流量均明显低于对照组(P<0.01)。术前和术后3 d,2组病人视觉模拟评分法评分差异均无统计学意义(P>0.05);术后3个月和6个月,观察组视觉模拟评分法评分均低于对照组(P<0.05和P<0.01)。术前2组病人日本骨科学会评分法评分差异无统计学意义(P>0.05);术后3 d、3个月和6个月,观察组日本骨科学会评分法评分均高于对照组(P<0.05~P<0.01)。2组手术前后各时点颈椎曲度、椎间隙高度差异均无统计学意义(P>0.05),2组病人术后各时点的颈椎曲度和椎间隙高度均较术前明显改善(P<0.01)。术后3个月,观察组病人生理功能、躯体角色功能、躯体疼痛、总体健康、活力、社会功能、情感角色功能和心理健康评分均高于对照组(P<0.05~P<0.01)。结论:自锁式零切迹颈椎融合器治疗颈椎病手术创伤小,病人术后神经功能和恢复效果较好,颈椎曲度和椎间隙高度得到明显改善,同时病人术后的生活质量明显提高,具有较好的临床治疗效果,值得推广应用。
Objective: To explore the clinical effects of self-locking zero incisure cervical vertebra fusion in the treatment of cervical spondylosis. Methods: The clinical data of cervical spondylosis patients treated with operation were retrospectively analyzed. The patients treated with self-locking zero incisure cervical vertebra fusion and corpectomy combined with interbody fusion cervical plate fixation were divided into the observation group and control group,respectively( 15 cases each group). The clinical effects between two groups were compared. Results: The operation time,intraoperative blood loss and postoperative drainage amount in observation group were significantly lower than those in control group( P < 0. 01). The differences of VAS scores between two groups before operation and after 3 days of operation were not statistically significant( P > 0. 05). After 3 and 6 months of operation,the VAS scores in observation group were significantly lower than those in control group( P < 0. 05 and P < 0. 01). The difference of the JOA score between two groups before operation was not statistically significant( P > 0. 05). After 3 days,3 months and 6 months of operation,the JOA scores in observation group were higher than those in control group( P < 0. 05 to P < 0. 01). The differences of the cervical curvature and intervertebral height between two groups before and after operation were not statistically significant( P > 0. 05). Compared with before operation,the cervical curvature and intervertebral height in two groups were significantly improved after operation( P < 0. 01). After 3 months of operation,the scores of physical function,body role function,body pain,general health,vitality,social function,emotional role function and mental health in observation group were higher that than those in control group( P < 0. 05 to P < 0. 01). Conclusions: The self-locking zero incisure cervical vertebra fusion in the treatment of cervical spondylosis has little trauma,the postoperative nerve function and recovery of patients are good,the postoperative cervical curvature,intervertebral height and life quality of patients are significantly improved,which is worthy of clinical application.
Objective: To explore the clinical effects of self-locking zero incisure cervical vertebra fusion in the treatment of cervical spondylosis. Methods: The clinical data of cervical spondylosis patients treated with operation were retrospectively analyzed. The patients treated with self-locking zero incisure cervical vertebra fusion and corpectomy combined with interbody fusion cervical plate fixation were divided into the observation group and control group,respectively( 15 cases each group). The clinical effects between two groups were compared. Results: The operation time,intraoperative blood loss and postoperative drainage amount in observation group were significantly lower than those in control group( P < 0. 01). The differences of VAS scores between two groups before operation and after 3 days of operation were not statistically significant( P > 0. 05). After 3 and 6 months of operation,the VAS scores in observation group were significantly lower than those in control group( P < 0. 05 and P < 0. 01). The difference of the JOA score between two groups before operation was not statistically significant( P > 0. 05). After 3 days,3 months and 6 months of operation,the JOA scores in observation group were higher than those in control group( P < 0. 05 to P < 0. 01). The differences of the cervical curvature and intervertebral height between two groups before and after operation were not statistically significant( P > 0. 05). Compared with before operation,the cervical curvature and intervertebral height in two groups were significantly improved after operation( P < 0. 01). After 3 months of operation,the scores of physical function,body role function,body pain,general health,vitality,social function,emotional role function and mental health in observation group were higher that than those in control group( P < 0. 05 to P < 0. 01). Conclusions: The self-locking zero incisure cervical vertebra fusion in the treatment of cervical spondylosis has little trauma,the postoperative nerve function and recovery of patients are good,the postoperative cervical curvature,intervertebral height and life quality of patients are significantly improved,which is worthy of clinical application.
引文
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[10]陈扬,赵忠玮,郭伟壮,等.ZERO-P内固定系统应用于颈前路椎间融合术的临床观察[J].中国骨与关节损伤杂志,2013,28(9):845.
[11]方大标,张平,孙洪体,等.前后路术式治疗多节段脊髓型颈椎病的对比研究[J].中国矫形外科杂志,2011,19(3):258.
[12]SCHEER JK,TANG JA,SMITH JS,et al.Cervical spine alignment,sagittal deformity and clinical implication:a review[J].J Neurosurg Spine,2013,19(2):141.
[13]华江,刘福存,王玮.ROI椎间融合器行前路颈椎间盘切除融合术治疗颈椎退行性病变早期临床结果[J].浙江中医药大学学报,2013,37(7):877.
[2]祁敏,梁磊,新伟,等.颈前路多节段融合术后吞咽困难的原因分析[J].中华骨科杂志,2013,33(5):467.
[3]马双,周先爱.零切迹椎间融合内固定Zero-P系统在颈椎前路手术中的应用效果[J].中国继续医学教育,2016,8(2):91.
[4]SCHOLZ M,SCHNAKE KJ,PINGEL A,et al.A new Zero-Profile implant for standalone anterior cervical interbody fusion[J].Clin Orthop Relat Res,2011,469(3):666.
[5]俞武良,陆建猛,韦勇力,等.零切迹椎间融合固定系统治疗颈椎间盘突出症的早期疗效观察[J].脊柱脊髓修复与功能重建,2013,27(6):686.
[6]姚海蓉.全程护理干预对老年糖尿病病人专科知识及生活质量的影响[J].齐鲁护理杂志,2015,21(21):24.
[7]祁敏,陈华江,杨立利,等.采用新型Zero-p颈椎椎间融合器置入治疗颈椎病的近期疗效分析[J].中国矫形外科杂志,2012,20(24):2232.
[8]徐灿华,吴增晖,张清顺,等.自锁式颈椎前路椎间融合治疗单间隙脊髓型颈椎病[J].中国骨科临床与基础研究杂志,2013,5(3):154.
[9]廖壮文,黄彦,范子文,等.微创小切口零切迹颈前路椎间融合器治疗单阶段脊髓型颈椎病的疗效评价[J].中国矫形外科杂志,2012,20(24):2250.
[10]陈扬,赵忠玮,郭伟壮,等.ZERO-P内固定系统应用于颈前路椎间融合术的临床观察[J].中国骨与关节损伤杂志,2013,28(9):845.
[11]方大标,张平,孙洪体,等.前后路术式治疗多节段脊髓型颈椎病的对比研究[J].中国矫形外科杂志,2011,19(3):258.
[12]SCHEER JK,TANG JA,SMITH JS,et al.Cervical spine alignment,sagittal deformity and clinical implication:a review[J].J Neurosurg Spine,2013,19(2):141.
[13]华江,刘福存,王玮.ROI椎间融合器行前路颈椎间盘切除融合术治疗颈椎退行性病变早期临床结果[J].浙江中医药大学学报,2013,37(7):877.