双插片自稳式融合器治疗颈椎间盘突出症的疗效观察

Clinical observation on ROC-I self-locking fusion cages for cervical disc herniation

目的评价颈前路减压双插片自稳式融合器（ROI-C）植骨融合治疗颈椎间盘突出症的临床疗效。方法回顾性分析自2011-10—2014-09采用颈前路减压ROI-C植骨融合治疗的34例颈椎间盘突出症,统计手术时间、术中出血量、并发症,测量术前术后颈椎曲度、病变节段椎间隙高度,并以植骨融合率、NDI指数、JOA评分、Odom标准评价临床疗效。结果本组随访时间14~31个月,平均21.6个月。单节段手术时间75~100 min,平均88 min。双节段手术时间105~125 min,平均113 min。术中出血量70~310 ml,平均195 ml。术后1例出现声音嘶哑,2例出现轻度吞咽困难,无切口感染。术后6个月,所有患者均获得骨性融合。末次随访时NDI指数（t=14.530,P〈0.001）、JOA评分（t=7.100,P=0.000 1）、椎间隙高度（t=3.620,P=0.000 4）及颈椎曲度（t=7.690,P〈0.001）均较术前明显改善,差异有统计学意义（P〈0.01）。末次随访时采用Odom标准评定疗效：优24例,良7例,可3例,优良率91.2%。结论颈前路减压ROC-I植骨融合治疗颈椎间盘突出症是一种创伤小和有效的手术方法,具有并发症少、疗效好的优点。

Objective To observe the clinical effects of anterior cervical discectomy and fusion with self-locking fusion cages（ROC-I） for the treatment of cervical disc herniation. Methods The clinical data of 34 cervical disc herniation cases which were performed with ROI-C from Oct. 2011 to Sep. 2014 were analyzed retrospectively. Neck Disability Index（NDI）, Japanese Orthopedics Association score, height of interbody space and curvature of cervical spine were measured before and after the surgery. And the clinical outcome was assessed by the bone fusion rate, and Odom scale. Results All patients were followed up for 14-31 months,with an average of 21.6 months. The single segment operation time was 88 minutes（75-100 minutes）,while the double segment operation time was 113 minutes（105-125 minutes）. The mean blood loss was 195 ml（70-310 ml）.There were hoarseness in 1 case and dysphagia in the other 2 cases. No infection of incision was found. The mean follow-up time was 21.6 months（14-31 months）. Bone fusion was proved by X-ray in all patients after 6 months＇ follow-up. According to the Odom scale, the excellent and good rate was 91.2%（24 excellent, 7 good）. In the last follow-up, NDI（ t =14.530, P〈0.001）, JOA scores（t =7.100, P =0.000 1）, the height of the disc space（t =3.620, P =0.000 4） and the curvature of the cervical spine（t =7.690,P〈0.001） changed significantly（P〈0.01）. Conclusion Anterior cervical discectomy and ROI-C self-locking fusion cage is an effective and less injury procedure, which can result in less complications and optimistic clinical outcome in the treatment of cervical disc herniation.