| 戎玉罗,罗勇骏,刘蔚,唐鹏宇,周快,殷国勇,蔡卫华*.零切迹自稳型颈椎融合器在前路颈椎椎间盘切除融合术中的应用及其对吞咽困难和邻近节段骨化的影响[J].脊柱外科杂志,2019,17(2):73-78. |
零切迹自稳型颈椎融合器在前路颈椎椎间盘切除融合术中的应用及其对吞咽困难和邻近节段骨化的影响  点此下载全文 (Fulltext) |
| 戎玉罗 罗勇骏 刘蔚 唐鹏宇 周快 殷国勇 蔡卫华* |
| 南京医科大学第一附属医院骨科, 南京 210029 |
| 基金项目：江苏省"六大人才高峰"C类资助项目（2014-WSN-012）；江苏省"333工程"科研项目（BRA2016512） |
| DOI：10.3969/j.issn.1672-2957.2019.02.001 |
| 摘要点击次数: 656 |
| 全文下载次数: 348 |
| 摘要： |
| 目的 比较在前路颈椎椎间盘切除融合术（ACDF）中应用零切迹自稳型颈椎融合器（ROI-C）与融合器并钛板固定治疗颈椎病的临床疗效、术后吞咽困难及远期邻近节段骨化的发生率。方法 回顾性分析2013年5月-2015年5月行ACDF治疗的108例颈椎病患者临床资料，其中59例应用ROI-C固定（A组），49例应用融合器并钛板固定（B组）。在术前、术后3个月及末次随访时，测量颈椎Cobb角、颈椎弓深、上位邻近节段椎间隙高度，并采用日本骨科学会（JOA）评分、颈椎功能障碍指数（NDI）评估患者颈椎功能。分别采用Odom法及Vaccraro标准进行手术疗效评定，记录2组术后吞咽困难及末次随访时邻近节段骨化发生情况。结果 与术前比较，2组术后JOA评分明显提高，NDI明显降低，颈椎Cobb角和弓深明显增大，差异均有统计学意义（P<0.05）；2组术后上位邻近节段椎间隙高度与术前比较差异均无统计学意义（P>0.05）。组间比较，术后JOA评分、NDI、手术疗效优良率和同时间点影像学参数差异均无统计学意义（P>0.05）。与B组相比，A组吞咽困难发生率和严重程度更低、持续时间更短，邻近节段骨化发生率也更低，差异有统计学意义（P<0.05）。结论 在ACDF中应用ROI-C治疗颈椎病安全、有效，与融合器并钛板固定相比，ROI-C能减少术后吞咽困难和邻近节段骨化的发生率。 |
| 关键词：颈椎病 椎间盘切除术 脊柱融合术 内固定器 手术后并发症 |
| Application of zero-profile anchored spacer in anterior cervical surgery and its effect on dysphagia and adjacent segmental ossification Fulltext |
| RONG Yu-luo LUO Yong-jun LIU Wei TANG Peng-yu ZHOU Kuai YIN Guo-yong CAI Wei-hua* |
| Department of Orthopaedics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China |
| Fund Project: |
| Abstract: |
| Objective To compare the clinical effects and incidence of postoperative dysphagia and adjacent segmental ossification of zero-profile anchored spacer (ROI-C) and cage combined titanium plate fixation in anterior cervical discectomy and fusion(ACDF). Methods The clinical data of 108 cervical spondylosis patients treated with ACDF from May 2013 to May 2015 were retrospectively analyzed. Among them, 59 underwent ROI-C fixation (group A) and 49 received cage combined titanium plate fixation(group B). At per-operation, postoperative 3 months and the final follow-up, the Cobb's angle of the cervical spine, depth of the cervical arch and height of the upper adjacent intervertebral space were measured, and the cervical spine function was evaluated by Japanese Orthopaedic Association (JOA) score and neck disability index (NDI). Odom criteria and Vaccraro criteria were used to evaluate the surgical efficacy. Dysphagia at post-operation and adjacent segmental ossification at the final follow-up were recorded. Results Compared with pre-operation, JOA score and NDI were significantly improved, and Cobb's angle and depth of the cervical arch were significantly increased in both groups, with statistical significances (P<0.05). There was no significant difference in the height of the upper adjacent intervertebral space between the 2 groups (P>0.05). There was no significant difference in JOA score, NDI, rate of excellent and good surgical effects and imaging parameters at the same time point between the 2 groups (P>0.05). Compared with group B, the incidence, severity and duration of dysphagia in group A were lower or shorter, and the incidence of adjacent segmental ossification was also lower in group A, with a statistical significance(P<0.05). Conclusion The application of ROI-C in ACDF is safe and effective in the treatment of cervical spondylosis. Compared with cage combined titanium plate fixation, ROI-C can reduce the incidence of dysphagia and adjacent segmental ossification. |
| Keywords:Cervical spondylosis Diskectomy Spinal fusion Internal fixators Postoperative complications |
|
|
HTML
查看全文 查看/发表评论 下载PDF阅读器 |
