颈前路带插片的融合器治疗颈椎病的早期疗效分析

Analysis of early-stage clinical results of ROI-C and MC + fusion cage used in anterior cervical operation

目的 :探讨颈前路带插片的融合器治疗颈椎病的早期疗效分析。方法 :回顾性分析2013年5月—2015年1月于本院行颈前路椎间盘切除减压带插片融合器(ROI-C型和MC+型)固定融合手术的47例颈椎病患者的早期疗效。ROI-C型融合器治疗23例,MC+融合器治疗24例。观察术前、术后3 d、术后3个月、末次随访时日本骨科协会(Japanese Orthopedic Association,JOA)评分、颈椎生理曲度、平均椎间高度、吞咽困难情况、3个月植骨融合率、出血量、手术时间、手术费用、住院时间。结果:所有患者手术顺利,平均随访时间(11.3±4.5)个月,一般情况良好,术后3个月和末次随访时JOA评分均较术前明显提高,差异有统计学意义。两种融合器术后颈椎生理曲度明显恢复,术后各时间点颈椎生理曲度较术前差异均有统计学意义,但两种融合器之间并未观察到统计学差异。术后各时间点平均椎间高度较术前明显增高。内植物下沉主要发生在早期,晚期也存在内植物下沉,但下沉距离小于早期下沉。术后有4例出现吞咽困难,术后7 d吞咽困难症状完全消失,随访时未再出现吞咽困难症状。术后3 d椎前软组织影厚度较术前差异有统计学意义,而术后3个月差异已无统计学意义。结论:带插片的颈椎融合器操作简便、手术时间短、术中出血少、术后恢复快、临床疗效满意,是用于颈椎前路手术治疗颈椎病的一种理想方法。

Objective： To explore the early-stage clinical results of ROI-C and MC ＋ fusion cage for patients treated by anterior cervical discectomy and fusion. Methods： Forty seven patients suffered from cervical spondylosis were treated by the same orthopedist with anterior cervical surgery（23 treated by ROT-C＋and 24 treated by MC（＋） from May 2013 to Jan 2015）. The evaluation indexes included Japanese Orthopaedic Association（JOA） scores,cervical physiological curvature,post-operative dysphagia,rate of bone fusion,intraoperative blood loss,duration of operation and costs of operation,duration of hospitalization were detected before suragury,postoperation 3 d,postoperation 3 month and the last follow-up respectively. Results： JOA scores of patients used ROI-C and MC＋ at three-month post operation and the last follow-up were better than JOA scores of pre-opertaion,and the differences were statistically significant. Cervical physiological curvature of patients used ROI-C and MC＋ at each follow-up time point was better than that of pre-operation. Average vertebral height at each follow-up time point was higher than that of pre-operation, the differences were statistically significant, but there were no statistical significances observed between ROI-C and MC＋. Only 4 patients with dysphagia in 3 day post-operation, and dysphagia was disappeared in 7-day post-operation. Anterior vertebral soft tissue at 3-day was thicker than that at pre-operation（P 〈0.05）, there were no statistical significances between pre-operation and last follow-up. Conclusion：The ROI-C and MC＋ fusion cage is a new kind of cage with less intraoperative blood loss, duration of operation and easy to operate.