颈前路ROI-C与传统钛板加Cage治疗颈椎间盘突出症疗效分析

发布时间：2018-04-08 22:01

本文选题：颈椎间盘突出症　切入点：脊柱融合　出处：《南京医科大学学报(自然科学版)》2017年12期

【摘要】：目的 :比较颈前路减压桥型融合器(ROI-C)置入与传统钛板加Cage治疗单节段颈椎间盘突出症的临床疗效。方法 :回顾性分析本院2013年5月—2014年12月行经颈前路手术治疗单节段颈椎间盘突出症患者54例,ROI-C组(A组)23例,传统钛板加Cage组(B组)31例,比较两组出血量、手术时间、术后颈痛视觉模拟评分(VAS评分)、术后JOA评分、颈椎生理曲度(Cobb角)、病变节段前凸角、融合率、吞咽困难发生率(Bazas评分)及邻近节段退变率。结果 :术后平均随访(15.7±2.4)个月,两组手术时间比较无统计学差异(P0.05),两组术中出血量有统计学意义(P0.05)。两组术后3个月及末次随访时JOA评分均高于术前水平(P0.05);颈痛VAS评分均较术前明显降低(PO.O5);两组术后颈椎前凸角较术前提高(P0.05)。A组术后出现轻度吞咽困难2例,B组11例,差异有统计学意义(P0.05),末次随访所有患者均骨性融合,内置物无松动、下沉。两组椎体融合率无差异(P0.05),末次随访中A组3例发生邻近节段退变,B组8例,差异无统计学意义。结论:颈椎前路减压术中应用椎间桥形融合器与传统钛板加Cage的临床疗效相似,但前者具有术中出血量少、术后吞咽困难发生率低等优点。
[Abstract]:Objective: to compare the clinical effect of anterior cervical decompression and bridge fusion cage (ROI-C) with traditional titanium plate and Cage in the treatment of single cervical disc herniation.Methods: 54 patients with single cervical disc herniation underwent anterior cervical approach from May 2013 to December 2014 were retrospectively analyzed. 23 patients in group A were treated with ROI-C and 31 patients in group B were treated with traditional titanium plate plus Cage. Blood loss and operation time were compared between the two groups.Postoperative cervical pain visual analogue score (VAS), postoperative JOA score, cervical physiological curvature and Cobb angle, segmental kyphoid angle, fusion rate, incidence of dysphagia and incidence of dysphagia (Bazas score) and adjacent degenerative rate.Results: the average postoperative follow-up was 15.7 卤2.4 months. There was no significant difference in the operative time between the two groups (P 0.05). The amount of intraoperative blood loss in the two groups was significantly higher than that in the control group (P 0.05).At 3 months after operation and at the last follow-up, the JOA score of both groups was higher than that of the preoperative level (P 0.05), the VAS score of cervical pain was significantly lower than that of the preoperation, and the cervical kyphosis angle after operation in both groups was significantly higher than that before operation in group A (n = 2) with mild dysphagia in group B (n = 11).The difference was statistically significant (P 0.05). Bone fusion was found in all the patients at the last follow-up.There was no difference in the rate of vertebral fusion between the two groups (P 0.05). In the last follow-up, there were 3 cases of adjacent segment degeneration in group A and 8 cases in group B, and there was no significant difference between the two groups.Conclusion: the clinical effect of anterior cervical decompression with bridged cage is similar to that of traditional titanium plate and Cage, but the former has the advantages of less intraoperative bleeding and lower incidence of dysphagia after operation.
【作者单位】：南京医科大学第一附属医院骨科;
【基金】：国家自然科学基金(81371967) 江苏省六大人才高峰(2014-WSN-012)
【分类号】：R687.3

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