一种新型固定融合系统治疗单节段神经根型颈椎病的疗效分析

Efficacy of anterior cervical decompression and internal fixation with a new low-notch plate fusion system for single-segment cervical spondylotic radiculopathy

背景:颈椎前路减压融合术是治疗单节段神经根型颈椎病(CSR)的经典术式,但存在诸多问题。目的:探讨单节段CSR采用颈椎前路减压新型低切迹接骨板一体化融合器系统(卡门同步适稳颈椎融合系统)内固定治疗的疗效。方法:回顾性分析2015年1月至2018年3月收治的58例单节段CSR患者,其中26例采用前路减压新型低切迹接骨板一体化融合器系统内固定治疗(观察组),32例采用传统钛板Cage椎间融合内固定治疗(对照组),比较两组患者手术时间、手术出血量、手术后吞咽困难发生率,术后疼痛视觉模拟评分(VAS)、日本骨科协会评分(JOA)、颈椎功能障碍指数(NDI)以及术后影像学的Cobb角和椎间隙高度。结果:观察组患者手术时间较对照组患者短,术中出血量也少,且差异均有统计学意义(P均<0.05)。所有患者均获得随访,随访12~18个月,平均随访(13.4±1.6)个月。术后1 d、1个月对照组患者术后吞咽困难发生率均高于观察组患者。而术前、术后3个月、12个月两组患者疼痛VAS评分、JOA评分以及NDI指数差异均无统计学意义。结论:新型低切迹接骨板一体化融合器系统内固定治疗单节段CSR的疗效与传统钛板Cage椎间融合内固定的疗效相当,具有手术时间短,术中出血量少、术后吞咽困难发生率低的优点。

Background:Anterior cervical discectomy and fusion(ACDF)is a classic operation for the treatment of single segment cervical spondylotic radiculopathy(CSR),but there are some shortcomings in it.Objective:To investigate the effect of ACDF with a new low-notch plate fusion system(Carmen system)for single-segment CSR.Methods:A retrospective analysis was made in 58 patients with single-segment CSR admitted to our hospital from January 2015 to March 2018.Twenty-six patients were treated with ACDF with Carmen system(observation group),and 32 patients were treated with ACDF with traditional titanium plate cage(control group).The operation time,intraoperative bleeding volume,incidence of postoperative dysphagia,VAS score,JOA score,NDI index,Cobb angle and intervertebral space height were compared between the two ignr otuhpes.coRnetsruollt sg:rTouhpe o(pPe<r0 a.t0 io5 n).tiTmhee amneda inn tdrauorapteiroanti voef fhoellmoowrr-huapg e wians t(h1 e 3 o.4 b s±e r1 v.6 at)i omno gnrtohus p(rwaenrgee,s i1 g2 ni-f i1 c8 a ntmlyo nltehsss)tihna na ltlh othsee patients.The incidence of dysphagia in the control group was significantly higher than that in the observation group one day and one month postoperatively.There was no significant difference in VAS score,JOA score,NDI,Cobb angle or intervertebral space height between the two groups(P>0.05).Conclusions:The new low-notch plate fusion system has similar effectiveness with traditional titanium plate cage interbody fusion and internal fixation in the treatment of single-segment CSR.However,it can significantly shorten operation time,reduce intraoperative bleeding and the incidence of postoperative dysphagia.