Zero-p与钛板+cage内固定治疗颈椎间盘突出近中期疗效对比

The Short-term and Medium-term Curative Effect Comparison between Zero-p and Conventional Titanium Plate Internal Fixation for the Treatment of Cervical Intervertebral Disc Herniation

目的讨论Zero-p与常规钛板内固定系统在治疗颈椎间盘突出近期、中期疗效上的差异。方法 2009年6月至2010年7月我科采用颈前路减压、Zero-p零切迹颈椎前路椎间融合固定系统治疗颈椎间盘突出症23例,同时期采用常规颈前路减压、钛板加Cage植骨融合内固定系统治疗25例,分别比较两组在术前及术后1年、5年随访中Bazaz吞咽困难分级、日本矫形外科学会评分(Japan orthopedic association,JOA)、症状改善率、颈椎功能障碍指数(the neck disability index,NDI);摄颈椎X线片评价植骨融合程度、内固定相关并发症及相邻节段异位骨化的发生。结果Zero-p组术后吞咽困难发生率和严重程度低于钛板cage组,术后1年症状改善率、JOA评分、NDI评分均得到明显改善。中期疗效评价中,两组患者极少发生内固定相关并发症;Zero-p相较于常规钛板内固定,在改善症状、提高生活质量、减低相邻节段异位骨化发生方面具有优势。结论 Zero-p相较于常规钛板内固定能有效降低吞咽困难发生,两组近期疗效相当,Zero-p中期疗效优于常规钛板内固定。

Objective To compare the Zero-p and conventional titanium plate internal fixation system in the short-term and medium-term curative effect. Methods The clinical data of 48 patients with cervical intervertebral disc herniation who underwent anterior cervical discectomy and fusion（ ACDF） by Zero-p implant（ n = 23） or traditional titanium plate with cage（ n = 25） between June 2009 and July 2009 were retrospectively analyzed. The Bazaz dysphagia grading、the Neck Disability Index（ NDI） 、Japanese Orthopaedic Association（ JOA） scoring、ameliorative rate of symptom in both groups were measured and compared. The radiographs of the cervical spine were made to assess bone graft fusion and internal fixation complications、adjacent-level ossification development. Results The incidence and severity of postoperatie dysphagia of Zero-p group were lower than the titanium plate group. Postoperative symptoms,JOA score,NDI scores of 1 year follow-up were improved significantly. At the medium-term evaluation of curative effect,the Zero-p was better than the conventional titanium plate internal fixation at improving symptoms,improving quality of life,reducing adjacent segmental heterotopic ossification occurred on competitive advantage. Conclusion Zero-p can effectively reduce the difficulty of swallow,compared with the conventional titanium plate internal fixation. The short-term curative effect of two groups is similar. At the medium-term evaluation of curative effect,the Zero-p is superior to the conventional titanium plate internal fixation.