采用自稳式双嵌片融合系统前路手术治疗神经根型颈椎病

The research on the application of double-plate self-locking cage for treatment of the cervical spondylotic radiculopathy

目的观察颈前路手术应用自稳式双嵌片融合系统（ROI-C）治疗神经根型颈椎病的临床效果。方法对35例神经根型颈椎病患者采用前路椎间盘切除、神经根减压、ROI-C植骨固定治疗。观察术前及术后3、6、12个月颈椎功能评分变化和椎间隙高度改变及植骨融合情况。结果 35例均获得随访,时间12-32个月。颈椎障碍指数由术前的36.1%±12.8%减少至术后12个月的9.8%±4.5%,差异有统计学意义（P〈0.05）。术后优良率为91.4%。椎间隙高度术前为5.1 mm±1.6 mm,术后12个月时为7.8 mm±0.5 mm,差异有统计学意义（P〈0.05）。2例患者分别出现声音嘶哑和吞咽困难,术后2周自愈。术后6个月X线或CT检查39个融合节段均获骨性融合。结论 ROI-C有良好的组织相容性,符合人体生物学特性,应用其治疗神经根型颈椎病具有创伤小、并发症少、融合率高、疗效好的优点。

Objective To discuss the efficacy of a new double-plate self-locking interbody fusion device（ ROI-C） in the anterior cervical discectomy and fusion（ ACDF） for treatment of cervical spondylotic radiculopathy. Methods The anterior cervical discectomy,radicular decompression and interbody fusion by RIO-C were performed in 35 patients. The neck disability index（ NDI） was recorded preoperatively and in the follow-up time to evaluate the clinical outcome,meanwhile,the preoperative and postoperative X-ray films of 3,6,12 months were accumulated to measure the height of interbody space and the rate of fusion. Results Thirty-five cases were followed up for 12 - 32 months.NDI decreased from 36. 1% ± 12. 8% preoperatively to 9. 8% ± 4. 5% in 12 months postoperation（ P〈0. 05）,the excellent-good rate was 91. 4%. The height of the disc space increased from 5. 1 mm ± 1. 6 mm preoperatively to 7. 8mm ± 0. 5 mm in 12 months postoperation,the change was statistically significant（ P〈0. 05）. Dysphagia in one patient and hoarseness in another patient were found,both of them were recovered spontaneously in two weeks. All of the 35 cases（ 39 levels） achieved bony fusion in 6 months according to X-ray film or CT image judgment. Conclusions There are many advantages in the treatment for cervical spondylotic radiculopathy with the ROI-C,such as good biological histocompatibility,minimally invasive procedure,less complications,high fusion rate,optimistic treatment outcome.