颈椎前路零切迹融合器治疗青年颈椎病的临床疗效分析

Anterior Cervical Zero-P Implantation for the Treatment of Cervical Spondylosis in Youths

目的比较采用Zero-P。颈椎固定融合器及常规颈前路间盘切除减压融合术（anterior cervical discectomy and fusion，ACDF）联合使用钛板、Cage治疗青年颈椎病的初期临床结果分析。方法2009年2月至2012年11月，采用手术治疗青年颈椎病患者47例，其中男性26例，女性21例，平均年龄22～38岁。按照患者自身意愿及手术所用器材的不同将患者分成A组（颈椎前路钛板、Cage）、B组（Zero-P颈椎固定融合器）两组。于术前、术后3d、术后3个月、术后半年、术后1年、术后2年等时间段通过日本矫形外科学会评分法（Japan orthopedic association，JOA），疼痛视觉模拟评分（visual analoguescale，VAS）、颈椎功能障碍指数（neckdisabilityindex，NDI）、对患者的神经功能情况进行评估；选用Bazaz吞咽困难评分法对术后出现吞咽困难及并发症的产生进行评估。结果所有患者术后都取得了满意的神经功能改善，两组患者术后JOA评分、VAS评分及NDI评分均较术前有显著提高；A组患者术后出现1例吞咽困难症状，B组患者术后1周内有11例出现吞咽困难。随访时期两组患者均没有出现内固定失效、感染等情况。结论Ze-ro-P颈椎固定融合器及颈椎前路钛板、Cage置入治疗青年颈椎病近期均取得良好的临床疗效，Zero-P术后吞咽困难发生率低。

Objective To discuss the early follow-up outcome of Zero-P implantation and anterior cervical phae and cage in treatment of cervical spondylosis in youths. Methods From Feb 2009 to Nov 2012,47 patients underwent Zero-P implanta- tion and anterior cervical plate,cage were included in this study. There were 26 males and 21 females. The age of the patients were 22 to 38 years. These patients were divided into two groups by their wishes and different operation equipment. The data were collected before surgery and at 3 day, 3,6,12 and 24 months after surgery. Clinical outcome and neurological function were evaluated by Japan orthopedic association（JOA） score ,Visual analogue scale（VAS） and neck disability index（NDI） Post- operative dysphagia associated complication were assessed by the Bazaz dysphagia score system. Results All the patients had a satisfied neurologic improvement. JOA, VAS and NDI scores showed significantly improvement after surgery. There were 11 patients complained of dysphagiain one week after surgery in group B and 1 patient complained in group A. No internal fixation failures or infection were observed during the follow-up perlod~ Conclusion Zero-P implantation, anterior cervical pltae and cage cervical spondylosis in youths have an excellent early clinical outcome in treatment of cervical spondylosis in youths. Zero- P has earned low postoperative dysphagia.