零切迹颈前路椎间融合固定系统治疗颈椎邻椎病的早期疗效分析

The early effect of zero-profile cage-plate device on the treatment of adjacent segment degeneration

目的回顾性分析应用零切迹颈前路椎间融合固定系统(Zero-P)治疗颈椎邻椎病的临床疗效、影像学结果及并发症。方法选择运用Zero-P治疗16例颈椎邻椎病患者,所有患者为单节段邻近节段退变,其中颈3/颈4有3例、颈4/颈5有10例、颈6/颈7有3例。记录手术前后颈部功能障碍指数(NDI)、上肢放射痛视觉模拟评分(VAS)、日本骨科协会评估颈椎病治疗分数(JOA)评分,分析X线、CT或MRI影像学改变,根据Bazaz标准分析术后的吞咽苦难情况。结果平均NDI指数和上肢放射痛VAS评分经手术后下降,末次随访JOA评分均较术前提高,手术前后有差异有统计学意义(t分别=25.02、13.16、6.28,P均<0.05)。末次随访时,15例患者达到骨性融合。术后早期有1例患者出现中度吞咽困难、1例患者出现轻度吞咽困难,均在术后6月症状消失。未出现内固定相关并发症及因四枚螺钉置入引起的椎体骨折。结论 Zero-P治疗颈椎邻椎病是简单安全有效的,术中可减少对邻近节段及原手术节段的干扰,且术后的吞咽困难发生率很低。

Objective To retrospectively analyze the clinical efficacy, imaging data and complications of zero-profile cage-plate device（Zero-P） for treating adjacent segment degeneration. Methods A total of 16 adjacent segment degeneration patients who were treated with Zero-P were selected. They were all singal level cervical adjacent segment degenera-tion. There were 3 cases of C3/C4,10 cases of C4/C5 and 3 cases of C6/C7. NDI, arm pain VAS scores and JOA scores were recorded and imaging included X-rays, CT and MRI were analyzed. Dysphagia was assessed using the Bazaz score.Results NDI and mean arm pain VAS score showed a statistically significant decreasing after treatment, and postoperative cervical JOA scores showed a significant improvement（t=25.02,13.16, 6.28, P0.05）. At the deadline, 15 patients had successful bone-fusion. One patients occurred moderate and one of mild transient dysphagia,both of them recovered after 6months. No device-related complications and fractures secondary to four screws insertion in one vertebral body occurred.Conclusions Zero-P is a simple, safe and effective treatment for cervical adjacent segment degeneration. It can reduce the interference to adjacent segments and the original operation segment, and postoperative dysphagia is rarely occurre.