颈前路减压零切迹融合与钛板联合cage融合术后相邻节段退变的比较

发布时间：2018-05-18 23:02

本文选题：颈椎病 + 颈前路减压植骨融合术　；参考：《中国骨与关节损伤杂志》2016年09期

【摘要】：目的比较颈前路减压钛板联合cage植骨融合内固定与零切迹椎间融合治疗单节段颈椎病术后对邻近节段退变的影响。方法回顾性分析自2009-06—2013-05采用颈前路减压钛板联合cage融合内固定(钛板组)及颈前路减压零切迹椎间植骨融合内固定术(零切迹组)治疗的49例颈椎病,钛板组24例,零切迹组25例。比较2组手术时间、术中出血量、NDI指数、JOA评分、Bazaz吞咽困难分级,测量颈椎曲度、相邻椎体角度位移及水平位移。结果 2组手术时间(t=0.789,P=0.347)、术中出血量(t=1.488,P=0.303)比较差异无统计学意义(P0.05)。49例均获得随访24~60个月,平均37.8个月。零切迹组吞咽困难发生例数少于钛板组,差异有统计学意义(χ~2=3.984,P=0.043)。术后6个月、末次随访时的NDI指数及JOA评分均较术前明显改善,差异有统计学意义(P0.05)。2组术后6个月及末次随访时颈椎曲度比较差异无统计学意义(P0.05);但钛板组术后6个月及末次随访时角度位移和水平位移均大于零切迹组,差异有统计学意义(P0.05)。结论颈前路减压钛板联合cage融合内固定与零切迹融合均能良好地改善临床症状和维持颈椎曲度,在减少吞咽困难、相邻椎体角度位移及水平位移方面,零切迹系统具有一定优势。
[Abstract]:Objective to compare the effect of anterior cervical decompression and titanium plate combined with cage bone grafting and internal fixation and zero notch intervertebral fusion on adjacent segment degeneration after single segment cervical spondylosis. Methods 49 cases of cervical spondylopathy treated with anterior cervical decompression combined with cage fusion and internal fixation (titanium plate group) and anterior cervical decompression with zero notch fusion and internal fixation (zero notch group) were retrospectively analyzed. 24 cases in titanium plate group were treated with cervical spondylopathy. Zero notch group 25 cases. The operative time, NDI index and Bazaz's dysphagia grade were compared between the two groups. The cervical curvature, angle displacement and horizontal displacement of adjacent vertebrae were measured. Results there was no significant difference in the operative time between the two groups (P 0.05, P 0.05, P 0.05) and the average of 37.8 months (mean, 37.8 months). The incidence of dysphagia in the zero notch group was less than that in the titanium plate group, and the difference was statistically significant (蠂 2 + 3.984). After 6 months, the NDI index and JOA score were significantly improved at the last follow-up. There was no significant difference in cervical curvature at 6 months after operation and at the last follow-up, but the angle displacement and horizontal displacement in the titanium plate group were higher than those in the zero notch group at 6 months after operation and at the last follow-up, and the difference was statistically significant (P 0.05). Conclusion anterior cervical decompression titanium plate combined with cage fusion internal fixation and zero notch fusion can improve clinical symptoms and maintain cervical curvature, and reduce dysphagia, angle displacement and horizontal displacement of adjacent vertebrae. Zero notch system has some advantages.
【作者单位】：宝鸡市中医医院骨科;
【基金】：陕西省卫生厅科研基金项目(2012C5)
【分类号】：R687.32

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