Zero-P颈椎前路椎间融合固定系统应用于单节段颈椎前路减压植骨融合术中的疗效分析

发布时间：2018-05-14 22:00

本文选题：颈椎间盘突出 + Zero-P(零切迹)　；参考：《浙江大学》2015年硕士论文

【摘要】：目的本研究的目的旨在分析在诊断为单节段颈椎间盘突出的患者中行颈椎前路减压植骨融合术中应用Zero-P(零切迹)颈椎前路椎间融合固定系统的疗效及其安全性。材料和方法共45个患者(27个男性患者和18个女性患者)纳入该研究,应用Zero-P颈椎前路椎间融合固定系统进行单节段颈椎前路减压植骨融合术。术后这些患者随访18到30个月(平均21.9个月)。对患者进行术前、术后JOA评分、Odom评级,应用Bazaz-Yoo吞咽困难评分评估术后吞咽困难发生率,以及测量椎间隙高度变化并对植骨融合情况进行评价。术前、术后均对颈椎进行x线、CT和MRI检查。结果 JOA评分和恢复率在随访3个月及12个月时均显著增加。手术的疗效在1年之内出现明显改变,1年之后,未见明显重大变化。术后7天时,出现吞咽困难相关症状的患者中,15例(33%)为轻度吞咽困难,1例(2.2%)为中度吞咽困难,所有吞咽困难的症状在3个月之内全部消失。结论从主要的临床及影像学角度讲,Zero-P颈椎前路椎间融合固定系统应用于单节段颈椎前路减压植骨融合术中的疗效是令人满意的,与传统的应用钢板及融合器的颈椎前路减压植骨融合术相比,它能够适当的减压,具有可靠的稳定性以及较低的术后吞咽困难发生率。随访期间未发现邻椎退行性改变及内植入相关并发症的发生。在接下来的研究中可能需要临床随机对照试验,更具有说服力。
[Abstract]:Purpose The purpose of this study was to evaluate the efficacy and safety of Zero-P anterior cervical interbody fusion system in patients with single cervical disc herniation. Materials and methods A total of 45 patients (27 male and 18 female) were included in the study and anterior cervical fusion and fixation system (Zero-P) was used to perform single-level anterior cervical decompression and fusion. These patients were followed up for 18 to 30 months (mean 21.9 months). Preoperative and postoperative JOA scores were used to evaluate the incidence of dysphagia and the height of intervertebral space was measured and bone graft fusion was evaluated with Bazaz-Yoo dysphagia score. X-ray CT and MRI were performed before and after operation. Result JOA score and recovery rate increased significantly at 3 and 12 months follow-up. The effect of the operation changed significantly within 1 year, but no significant change was observed after 1 year. At 7 days after operation, 15 patients with dysphagia related symptoms were found to be mild dysphagia (1 patient with moderate dysphagia), and all symptoms of dysphagia disappeared within 3 months. Conclusion The application of Zero-P anterior cervical interbody fusion and fixation system in single-level anterior cervical decompression and fusion is satisfactory from the major clinical and imaging points of view. Compared with the traditional anterior decompression and fusion of cervical vertebrae with plate and cage, it has the advantages of proper decompression, reliable stability and low incidence of dysphagia. No degenerative changes of adjacent vertebrae and complications associated with internal implantation were found during follow-up. Clinical randomized controlled trials may be needed in subsequent studies to be more persuasive.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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