零切迹颈椎间隙融合器固定融合治疗颈椎病近远期疗效观察的前瞻性研究
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摘要
目的:探讨零切迹颈椎间隙融合器固定融合治疗颈椎病近远期疗效差异。方法:将我院94例颈椎病患者按随机数表法分为观察组与对照组各47例。观察组给予零切迹颈椎间隙融合器固定融合术治疗,对照组给予传统前路钛板联合Cage融合器系统治疗,对比两组手术相关指标、日本骨科学会(JOA)评分、椎体间高度、植骨融合率及并发症发生率。结果:观察组手术时间短于对照组,差异有统计学意义(P<0.05)。两组术后出血量、引流量比较无统计学意义(P>0.05)。两组术后3个月、6个月、12个月、36个月JOA评分均高于术前,差异有统计学意义(P<0.05)。两组术后各时点JOA评分比较无显著差异(P>0.05)。观察组术后3个月植骨融合率高于对照组,差异有统计学意义(P<0.05)。两组术后6个月全部病例植骨融合。两组术后各时点椎体间高度均高于术前(P<0.05),但组间比较无显著差异(P>0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:与传统前路钛板联合Cage融合器系统治疗相比,零切迹颈椎间隙融合器固定融合治疗颈椎病近远期疗效相似,但其手术时间更短,早期植骨融合率更高,而且术后并发症发生率低,更具临床应用价值。
Objective: To investigate the short-term and long-term difference in the treatment of cervical spondylosis with the fixed fusion of zero notch cervical intervertebral space fusion cage. Methods: 94 cases of patients with cervical spondylosis in our hospital were randomly divided into observation group and control group of 47 cases. The observation group was treated with fixed fusion with zero incisor cervical intervertebral space fusion cage,and the control group was treated with the traditional anterior titanium plate combined with Cage fusion system. The two groups of surgical related indexes,the Japanese Department of orthopedics( JOA) score,the interbody height,the fusion rate of bone graft and the incidence of complications were compared. Results: The operation time of the observation group was shorter than that of the control group( P <0.05). The amount of bleeding and the flow rate of the two groups were not statistically significant( P >0.05). 3 months,6 months,12 months and 36 months after operation,the JOA scores in the two groups were all higher than those before the operation( P <0.05). There was no significant difference in JOA scores at each time point between the two groups( P >0.05). The fusion rate of bone graft in the observation group was higher than that of the control group at 3 months after the operation( P < 0.05). All the two groups had bone graft fusion at 6 months after operation. The intervertebral height at all time points in the two groups was higher than that before the operation( P <0.05),but there was no significant difference between the groups( P >0.05). The incidence of complications in the observation group was lower than that of the control group( P < 0. 05). Conclusion:Compared with the traditional anterior titanium plate combined with Cage fusion system for the treatment of cervical intervertebral fusion device,zero notch fixation and fusion in treatment of cervical vertebra disease curative effect is similar,but the shorter operation time,early bone graft fusion rate is higher,and the incidence of postoperative complications is low,more clinical value.
Objective: To investigate the short-term and long-term difference in the treatment of cervical spondylosis with the fixed fusion of zero notch cervical intervertebral space fusion cage. Methods: 94 cases of patients with cervical spondylosis in our hospital were randomly divided into observation group and control group of 47 cases. The observation group was treated with fixed fusion with zero incisor cervical intervertebral space fusion cage,and the control group was treated with the traditional anterior titanium plate combined with Cage fusion system. The two groups of surgical related indexes,the Japanese Department of orthopedics( JOA) score,the interbody height,the fusion rate of bone graft and the incidence of complications were compared. Results: The operation time of the observation group was shorter than that of the control group( P <0.05). The amount of bleeding and the flow rate of the two groups were not statistically significant( P >0.05). 3 months,6 months,12 months and 36 months after operation,the JOA scores in the two groups were all higher than those before the operation( P <0.05). There was no significant difference in JOA scores at each time point between the two groups( P >0.05). The fusion rate of bone graft in the observation group was higher than that of the control group at 3 months after the operation( P < 0.05). All the two groups had bone graft fusion at 6 months after operation. The intervertebral height at all time points in the two groups was higher than that before the operation( P <0.05),but there was no significant difference between the groups( P >0.05). The incidence of complications in the observation group was lower than that of the control group( P < 0. 05). Conclusion:Compared with the traditional anterior titanium plate combined with Cage fusion system for the treatment of cervical intervertebral fusion device,zero notch fixation and fusion in treatment of cervical vertebra disease curative effect is similar,but the shorter operation time,early bone graft fusion rate is higher,and the incidence of postoperative complications is low,more clinical value.
引文
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[12]李玉伟,王海蛟,严晓云,等.颈前路减压零切迹椎间融合器与钉板系统内固定治疗脊髓型颈椎病的疗效比较[J].中华骨科杂志,2015,35(11):1136~1141.
[13]赵康全,王晟昊,王羿萌,等.自锁式颈椎融合器ROI-C与前路钛板固定联合cage植骨融合治疗老年性脊髓型颈椎病的对比研究[J].骨科,2015,6(5):244~247.
[2]陈琦,徐南伟,张宁.脊髓型颈椎病前路椎体次全切除钛网植骨融合内固定术的回顾性分析[J].实用临床医药杂志,2016,20(19):88~90.
[3]Martin-Vaquero P,Costa R C D.Body conformation in great danes with and without clinical signs of cervical spondylomyelopathy[J].Veterinary Journal,2015,203(2):219~222.
[4]Jang J,Jeon S W,Chae H,et al.Low complexity zeroforcing precoder design under per-antenna power constraints[J].IEEE Communications Letters,2015,19(9):1556~1559.
[5]Kuwabara T,Nakada M,Hamada J,et al.(η(4)-Butadiene)Sn(0)complexes:a new approach for zero-valent p-block elements utilizing a butadiene as a 4π-electron donor[J].Journal of the American Chemical Society,2016,138(35):11378.
[6]Martin-Vaquero P,Costa R C D.Body conformation in Great Danes with and without clinical signs of cervical spondylomyelopathy[J].Veterinary Journal,2015,203(2):219~222.
[7]任永安.颈椎前路减压椎间植骨融合钛板内固定治疗多节段脊髓型颈椎病[J].临床骨科杂志,2017,20(3):268~271.
[8]Min Q I,Liang L,Chen H J.Learning curve of zero-p implantation in ACDF procedure for surgical treatment of cervical spondylosis[J].Orthopedic Journal of China,2013,21(3):213~216.
[9]王兴平,杨武军.颈前路零切迹椎间融合固定系统与传统钛板联合Cage融合内固定在双节段脊髓型颈椎病的近期疗效对比[J].颈腰痛杂志,2016,38(6):90~92.
[10]常步青,冯虎,于朝将,等.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.
[11]管华清,杨惠林,姜为民,等.新型零切迹桥形锁定融合器治疗脊髓型颈椎病的早期疗效[J].中国矫形外科杂志,2015,23(9):794~799.
[12]李玉伟,王海蛟,严晓云,等.颈前路减压零切迹椎间融合器与钉板系统内固定治疗脊髓型颈椎病的疗效比较[J].中华骨科杂志,2015,35(11):1136~1141.
[13]赵康全,王晟昊,王羿萌,等.自锁式颈椎融合器ROI-C与前路钛板固定联合cage植骨融合治疗老年性脊髓型颈椎病的对比研究[J].骨科,2015,6(5):244~247.