桥型椎间融合器(ROI-C)在手术治疗外伤性颈椎间盘突出症中的应用

Clinical application of ROI-C interbody fusion cage for treatment of injured cervical disc protrusion

目的探讨桥型椎间融合器(ROI-C)在颈椎前路椎间盘切除椎间植骨融合内固定术治疗外伤性颈椎间盘突出症中应用的价值及效果。方法回顾性分析自2013-06—2015-02采用桥型椎间融合器(ROI-C)进行颈前路椎间盘切除植骨融合内固定术治疗的24例外伤性颈椎间盘突出症。比较术前、术后7 d、术后6个月及末次随访时的临床及影像学指标。结果本组手术时间75~110 min,平均93 min;术中出血量80~200 ml,平均110 ml。24例均获得随访10~29个月,平均18个月。术后2例出现暂时性吞咽困难,Bazaz分级均为轻度吞咽困难,对症处理1周后缓解。术后7 d、术后6个月、末次随访时的JOA评分、VAS评分、NDI指数、Cobb角、颈椎曲度及椎间高度较术前明显改善,差异均有统计学意义(P<0.05)。术后6个月、末次随访时的JOA评分、VAS评分、NDI指数较术后7 d进一步改善,差异均有统计学意义(P<0.05);而术后6个月及末次随访时比较差异无统计学意义(P>0.05)。术后6个月、末次随访时的Cobb角、颈椎曲度及椎间高度维持良好,与术后7 d比较差异无统计学意义(P>0.05)。结论颈前路椎间融合器ROI-C具有零切迹及自稳定的特性,在融合节段获得骨性融合的同时,减少了颈前路内固定系统的相关并发症,其应用于治疗外伤性颈椎间盘突出症安全有效。

Objective To evaluate the safety and effectiveness of ROI-C interbody fusion cage for treatment of injured cervical disc protrusion. Methods Between June 2013 and February 2015, 24 patients with injured cervical disc protrusion underwent anterior disectomy and fusion with ROI-C interbody fusion cage. The Cobb angle and disc space height（DSH） were measured on X-ray film at each follow up duration, and the interbody fusion was evaluated on sagittal plane reconstruction CT. The visual analog scale （VAS）, neck disability index （NDI）, Japanese orthopedics association score （JOA） were used to evaluate the statue of clinical recovery. Meanwhile Bazaz scale was used to assess the severity of dysphagia at follow up. Results The duration of surgery was 75-110 min（mean, 93 min）, the blood loss was 80-200 ml（mean, 110 ml）. All patients were followed up for 10-29 months （mean, 18 mouths）. There were 2 patients with temporary dysphagia, classified as mild by Bazaz classification, and obtaining remission by treatment after one week. The JOA, VAS and NDI scores were significantly improved at 7 d, 6 months after operation and at the last follow-up compared with preoperative ones （P 〈0.05）, but no significant difference was found between at 6 months and last follow-up （P 〉0.05）. The Cobb angle and DSH was significantly improved at 7 d, 6 months after operation and at the last follow-up compared with preoperative ones （P 〈0.05）, but no significant difference was found between at 6 months and last follow-up （P 〉0.05）. Conclusion With the property of zero profile and self-locking, the ROI-C cage is safe and effective to treat injured cervical disc herniation, with good bony fusion at operation segment and decreased anterior cervical internal fixation related complications.