颈前路零切迹自锁椎间融合器治疗三节段颈椎病的初期临床结果

Preliminary clinical outcomes of anterior cervical discectomy and fusion using zero-profile and self-locking cages for three-level cervical spondylosis

目的分析颈前路应用颈椎零切迹自锁椎间融合器治疗三节段颈椎病的早期疗效。方法2011年12月至2012年6月手术治疗三节段颈椎病患者35例,男23例,女12例,平均年龄46.7（35-72）岁,平均病程9.7（3-32）个月。比较患者手术前后视觉疼痛模拟评分（visual analogue scale,VAS）、日本骨科协会（Japanese orthopaedic association,JOA）评分、颈椎功能障碍指数（neck disability index,NDI）以及手术节段的前凸角。结果所有患者均成功完成手术,术中出血量平均（95±43）ml,手术时间平均（118±19）min。随访时间6个月,术后1周、6周、3个月、6个月的VAS评分（颈部和上肢）、JOA评分、NDI较术前均有明显改善,差异有统计学意义（P〈0.05）。颈椎手术节段前凸角术前为（7.4±3.5）°,术后1周、6周、3个月、6个月分别为（15.6±3.1）°、（15.2±2.5）°、（14.9±3.5）°、（14.9±3.9）°,与术前相比差异有统计学意义（P〈0.05）。结论应用颈椎零切迹自锁椎间融合器治疗三节段颈椎病具有切口小、出血量少、视野清晰、安全、创伤小等优点,早期疗效满意,可重建患者颈椎曲度,稳定性可靠。

Objective To analyze the early outcomes of anterior cervical discectomy and fusion（ ACDF） using zero-profi le and self-locking cages in the treatment of 3-level cervical spondylosis. Methods From December 2011 to June 2012, 35 patients with 3-level cervical spondylosis underwent ACDF with zero-profi le and self-locking cages. There were 23 males and 12 females, whose mean age was 46.7 years old（ range： 35-72 years） and mean course was 9.7 months（ range： 3-32 months）. Study parameters included the visual analogue scale（ VAS） score, Japanese Orthopaedic Association（ JOA） score, neck disability index（ NDI） and lordosis angle of the cervical spine. Results The operation was successfully performed in all the cases. The mean operation time was（ 118±19） min and the mean blood loss was（ 95±43） ml. The follow-up period was 6 months. When compared with the preoperative scores, the VAS scores of neck and upper limb pain, JOA scores and NDI were obviously improved at 1 week, 6 weeks, 3 months and 6 months after the surgery. There were statistically signifi cant differences among them（ P〈0.05）. The lordosis angle of the cervical spine was（ 7.4±3.5） ° preoperatively, which was increased to（ 15.6±3.1） °,（ 15.2±2.5） °,（ 14.9±3.5） ° and（ 14.9±3.9） ° at 1 week, 6 weeks, 3 months and 6 months after the surgery, and statistically significant differences existed（ P0.05）. Conclusions The early outcomes of ACDF using zero-profile and selflocking cages for 3-level cervical spondylosis is satisfactory and reliable, and the cervical alignment can be restored. The surgery has the advantages of small incision, less bleeding, clear surgery fi eld, high safety and little trauma.