Zero-P椎间融合器颈椎前路置入内固定治疗颈椎病的优势

Advantages of an anterior cervical Zero-P implant for cervical spondylosis

背景:颈前路椎间盘切除减压植骨融合使用颈前路钢板可能引起治疗后吞咽困难等并发症。目的:观察采用颈椎前路一体化Zero-p椎间融合器置入治疗颈椎病的临床疗效以及减少治疗后并发症的优势。方法:采用颈椎前路一体化Zero-p椎间融合器行颈前路椎间盘切除减压植骨融合治疗颈椎病患者51例。在治疗前、治疗后第3天,治疗后3,6个月,治疗后1年及2年等时间节点采用颈部及上肢疼痛目测类比评分、颈椎功能障碍指数、日本矫形外科学会评分法对患者的神经功能情况进行评估;采用吞咽困难评分法对患者术后吞咽困难相关并发症的发生情况进行评估;拍摄颈椎正侧位及动力位X射线片评价术后植骨融合程度及内固定相关并发症情况。结果与结论:患者随访时间为6-30个月,平均15.4个月。治疗后切口均Ⅰ期愈合,所有患者治疗后获得疼痛缓解,肌力恢复;目测类比评分及颈椎功能障碍指数评分均较术前有显著改善;脊髓型颈椎病患者日本矫形外科学会评分平均改善率为85.7%。治疗后第2天有7例患者出现轻、中度的吞咽困难。随访期间未发现内置物沉降,也未发生螺钉松动、断裂或内固定器移位等并发症。表明颈前路椎间盘切除减压植骨融合式中采用颈椎前路一体化Zero-p椎间融合器置入治疗颈椎病的近期临床效果良好,其设计同时具备了颈椎间融合器以及颈椎前路固定钢板的优点,内固定相关并发症少。

BACKGROUND：The application of anterior cervical plate for anterior cervical discectomy and fusion wil induce some complications such as dysphagia after treatment. OBJECTIVE：To observe the clinical efficacy of the new implant Zero-P system for cervical spondylosis patients and its effect on reducing complications after treatment. METHODS：A total of 51 cervical spondylosis cases underwent anterior cervical discectomy and fusion using Zero-P system. Neurological function was evaluated by neck/arm visual analogue scale, neck disability index and Japanese Orthopaedic Association scores pretreatment, at 3 days, 3, 6 months, 1, 2 years post-treatment. The incidence of postoperative dysphagia was evaluated using dysphagia score. Anteroposterior＆amp;lateral and dynamics X-ray films were used to evaluate the efficacy of graft fusion and internal fixation-related complications. RESULTS AND CONCLUSION：The patients were fol owed up for 6-30 months, averagely 15.4 months. After treatment, their incision achieved stage I healing. Pain was relieved and muscle force was restored in al patients after treatment. Visual analogue scale and neck disability index scores were apparently improved. Improvement rate of Japanese Orthopaedic Association score was 85.7%. At 2 days after treatment, seven patients experienced mild and moderate dysphagia. During fol ow up, implant subsidence was not observed. No complications, such as screw loose, breakage or fixator displacement, were found. Results suggested that the new cervical stand-alone anterior fusion device in anterior cervical discectomy and fusion procedure for the＆amp;nbsp;treatment of cervical spondylosis has offered an excellent clinical outcome. Its design has the advantages of cervical interbody fusion and anterior cervical plate. There were less relevant complications.