颈前路零切迹自锁融合器治疗跳跃型颈椎病早期疗效观察

Clinical outcomes of anterior cervical discectomy and self-locking cage fusion for skip cervical spondylosis

目的观察分析颈前路零切迹自锁融合器治疗跳跃型颈椎病的早期临床疗效，评价手术对邻近颈椎退变的影响。方法回顾性分析自2013—06—2014—06采用颈前路零切迹自锁融合器治疗的跨节段颈椎病13例，共置入椎间融合器26枚。结果本组手术时间80～120（95．00±11．18）Min，术中出血量70～120（93．85±16．60）ml。术后吞咽困难l例，予以对症处理后有所好转．末次随访时无症状。定期随访至术后1年。术后随访大多数患者椎间盘未见明显退变，1例Kellgren颈椎退变分级由0级退变为1级：1例Miyazaki椎间盘退变分级由Ⅰ级退变为Ⅱ级，1例由Ⅱ级退变为Ⅲ级。术后1周VAS评分、术后6个月JOA评分较术前明显改善，差异有统计学意义（P〈0．05）。术后椎间隙高度（7．45±0．21）Mm，较术前明显增高，差异有统计学意义（P〈O．05）。结论颈前路零切迹自锁融合器治疗跳跃型颈椎病的初期疗效满意，临床症状缓解明显，颈椎椎间隙融合率高，并发症少，可减缓邻近颈椎的退变。

Objective To observe the early clinical effect of anterior cervical discectomy and serf-locking cage fusion for the skip eervical spondylosis, and evaluate the effects on degeneration of the adjacent cervical vertebrae. Methods The clinical data of 13 patients with anterior cervical discectomy and fusion from June 2013 to June 2014 were analyzed. All of them had a disease with skip cervical spondylosis. Twenty six cages were implanted. Results Operation time of this group were 80- 120 （95.00±11.18）min, amount of bleeding during operation was 70-120 （93.85±16.60）ml. Dysphagia happened in 1 case after surgery, and symptoms improved after symptomatic treatment, and there were no symptoms at the last follow-up. Postoperative follow-up of most patients showed no intervertebral disc degeneration. Intervertebral disc of one case based on Kellgren standard changed from level 0 to level 1, one case based on Miyazaki standard changed from level Ⅰ to level Ⅱ, and another changed from level Ⅱ to level Ⅲ. Postoperative VAS at 1 week after operation and JOA score at 6 months after operation were improved compared with those before operation. There was a significant difference before and after surgery （P 〈0.05）. The postoperative intervertebral height was （7.45±0.21）mm, it significantly increased compared with that before operation（P 〈0.05）. Conclusion This new anterior cervical self-locking fusion for treatment of skip cervical spondylosis has a satisfactory early curative effect. It also has the advantage of high eervical fusion rate, fewer complications, reliable stability, and decrease of the degeneration of adjacent cervical vertebra.