颈前路减压术中有无钛板固定对术后短期疗效的影响

Effect of anterior cervical decompression with or without titanium plate fixation on the short-term curative effect in this surgery

目的探讨颈椎前路减压术中有无钛板固定对手术后短期疗效的影响。方法回顾性分析接受颈前路减压手术治疗的81例单节段颈椎间盘突出症(CDH)患者的临床资料,根据术中是否行钛板固定将其分为A组(椎间融合器+钛板组)44例和B组(单纯椎间融合器组)37例,观察2组患者术前及术后JOA评分、颈椎曲度指数(CCI)的变化及轴性症状(AS)发生情况。结果 2组患者术后3个月及末次随访时JOA评分较术前均有明显恢复(P均<0.05),各时间点组间比较差异无统计学意义(P均>0.05)。A组手术前后CCI变化为(2.3±0.8)%,B组为(5.3±1.4)%,2组比较差异有统计学意义(P<0.05)。2组患者AS发生率分别为7%和24%,2组比较差异有统计学意义(P<0.05)。结论颈椎前路减压后单纯置入椎间融合器对手术疗效无影响,但会增加术后AS的发生。

Objective It is to investigate the short-term clinical therapeutic discrepancy of anterior cervical decompression with or without titanium plate fixation. Methods The clinical data of 81 cases of single segment cervical disk herniation patients who accepted anterior cervical decompression and fusion were retrospectively analyzed. The patients were divided into group A （ n = 44） treated with cervical interbody fusion cage and titanium plate and group B （ n = 37 ） treated with the cage only according to whether using titanium plate fixation or not in the surgery. The changes of JOA scores and cervical curvature index （CCI） before and after operation, and the incidence of axial symptoms were recorded and analyzed in both groups. Results JOA scores were obviously improved in 3 months after operation and at the finai follow-up compared with that before treatment in both groups（P 〈 0.05 ） , and the difference in the scores at every time point was not significant between the two groups （ P 〉 0.05 ）. The change of CCI in group A and group B was （2.3 ±0.8 ） % and （5.3 ±1.4） % respectively, compared with each other, the difference was significant （P 〈0.05） , and the incidence of axial symptoms was 7% in group A and 24% in group B, there was significant difference between the two groups （P 〈 0. 05 ）. Conclusion Simple insertion of cervical interbody fusion cage after anterior cervical decompression has no negative effect on the curative effect. However, without the plate fixation, axial symptoms tends to occurred after the surgery.