Anterior cervical interbody fusion with Zero-P for treatment of traumatic cervical disc herniation with spinal cord injury
ZHOU Feng, ZHONG Chuan-li, ZHU Shi-qing
Department of Spinal Surgery, Yubei District People's Hospital of Chongqing, Chongqing 401120, China
To compare the clinical efficacy of anterior cervical interbody fusion with Zero-P and titanium plate combined with Cage in the treatment of traumatic cervical disc herniation (TCDH) with spinal cord injury.
The clinical data of 78 TCDH patients with spinal cord injury from February 2012 to November 2015 were retrospectively analyzed. Thirty-eight patients were treated by anterior cervical discectomy and Cage plate internal fixation and fusion(Cage group), and the other 40 by anterior cervical interbody fusion with Zero-P internal fixator(Zero-P group). Frankel classification, cervical curvature, intervertebral fusion rate and the occurrence of dysphagia were compared between the 2 groups before operation and postoperative follow-up period.
All the patients were followed up for 12-37(15.76±3.80)months. The Frankel classification was significantly improved compared with the preoperation in the 2 groups, and the difference was statistically significant(P < 0.05);but there was no significant difference between the 2 groups(P > 0.05). The cervical curvature was also significantly improved compared with pre-operation in the 2 groups, and the difference was statistically significant(P < 0.05); but there was no significant difference between the 2 groups(P > 0.05); and there was no loss of the curvature until the final follow-up. Postoperative 3 months, the fusion rate of Zero-P group was higher than that of Cage group, and the incidence of dysphagia was significantly lower than that in Cage group; the difference was statistically significant(P < 0.05). There was no significant difference in fusion rate between the 2 groups at the final follow-up(P > 0.05).
Anterior cervical interbody fusion with Zero-P and titanium plate combined with Cage are effective treatments for TCDH with spinal cord injury, but the Zero-P internal fixator has advantages of high fusion rate at early post-operation and a lower dysphagia incidence.
注：*与术前相比，P < 0.05；△与Cage组相比，P < 0.05 Note：*P < 0.05，compared with pre-operation；△P < 0.05，compared with Cage group
表 2 统计数据
Table 2 Statistical data
女，52岁，C4/C5/C6椎间盘突出并脊髓损伤，采用Zero-P行椎间融合术a：术前MRI显示C4/C5/C6椎间盘突出并脊髓损伤b：术后48 h X线片示内固定位置良好c：术后3个月X线片示颈椎生理曲度恢复，植骨融合d：术后24个月MRI示内固定位置良好，无断裂
Female, 52 years old, C4/C5/C6 herniation and spinal cord injury, Zero-P interbody fusion a:Preoperative MRI suggests that C4/C5/C6 disc herniation with spinal cord injury b:Roentgenograph at postoperative 48 h shows internal fixation at good position c:Roentgenograph at postoperative 3 months shows recovery of cervical curvature and bone fusion d:MRI at postoperative 24 months shows internal fixation at good position without breakage
图 1 Zero-P组典型病例影像学资料
Figure 1 Imaging data of a typical case in Zero-P group
男，56岁，C3/C4/C5/C6脊髓型颈椎病，采用Cage行椎间融合术a：术前MRI示C3/C4/C5/C6椎间盘突出并脊髓损伤b：术后48 h X线片示内固定位置良好c：术后3个月X线片示颈椎生理曲度稍有恢复，但植骨未融合d：术后24个月MRI示Cage位置良好，植骨融合，颈椎生理曲度改善
Men, 56 years old, C3/C4/C5/C6 cervical spondylotic myelopathy, interbody fusion with Cage a:Preoperative MRI suggests that C3/C4/C5/C6 disc herniation with spinal cord injury b:Roentgenograph at postoperative 48 h shows internal fixation at good position c:Roentgenograph at postoperative 3 months shows little recovery of cervical curvature without bone fusion d:MRI at postoperative 24 months shows that Cage in good position, bone fusion and improvement of cervical physiological lordosis
图 2 Cage组典型病例影像学资料
Figure 2 Imaging data of a typical case in Cage group
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