颈前路减压零切迹自锁椎间融合内固定治疗颈椎病的早期疗效分析

Short-term clinical effect of Zero-profile interbody fusion device on cervical spondylosis

目的探讨颈前路零切迹椎间融合固定系统(Zero-P)治疗颈椎病的早期疗效。方法回顾性分析2012年10月至2015年10月深圳市宝安区人民医院采用颈前路减压Zero-P治疗的颈椎病患者36例,其中神经根型颈椎病12例,脊髓型颈椎病10例,混合型14例;31例为单节段手术,5例为双节段手术。采用日本骨科协会(JOA)评分及颈椎功能障碍指数(NDI)评价临床疗效,并观察患者术后并发症及植骨融合情况。结果 36例患者平均手术时间为(45.0±12.3)min,术中平均出血量为(40.0±15.2)m L,随访时间12~28个月,平均(16.1±3.4)个月。治疗前JOA评分为8.30±1.13,术后1个月及末次随访时JOA评分分别为12.16±1.07、14.33±1.01,JOA评分较术前有显著提高(P<0.01);术前NDI为25.04±5.31,术后1个月及末次随访时NDI分别为13.37±2.81、11.53±7.01,NDI较术前显著降低(P<0.05)。所有患者未发生食管及神经、血管损伤,术后无饮水呛咳及吞咽困难发生,未发现融合器移位、沉降和螺钉松动、断裂等,植骨融合率为100.0%。结论颈前路减压Zero-P治疗颈椎病操作简单,融合可靠,术后吞咽不适发生率低,其早期临床疗效满意。

Objective To evaluate the short-term effect of Zero-profile interbody fusion device on cervical spondylosis.Methods The clinical data of 36 patients with cervical spondylosis who underwent the internal fixation with Zero-profile interbody fusion device in the People＇s Hospital of Bao＇an District of Shenzhen City from October 2012 to October 2015 were analyzed retrospectively. The 36 patients included 12 cases of cervical spondylotic radiculopathy,10 cases of cervical myelopathy,14 cases of mixed type of cervical spondylosis. Thirty-one patients underwent single segment surgery,five patients underwent double segment surgery. The clinical effect was evaluated by Japanese Orthopedics Association（ JOA） and neck disability index（ NDI）. The postoperative complications and bony union were observed. Results The average operation time of the 36 cases was（ 45. 0 ± 12. 3） minutes,the average intraoperative blood loss was（ 40. 0 ± 15. 2） m L,and the average follow-up time was（ 16. 1 ± 3. 4） months（ 12- 28 months）. The JOA score at the time points of pretherapy,one month after operation and the last follow-up was 8. 30 ± 1. 13,12. 16 ± 1. 07 and 14. 33 ± 1. 01,respectively; the JOA scores at the time points of one month after operation and the last follow-up were significantly higher than those before treatment（ P〈0. 01）. The NDI score at the time points of pretherapy,one month after operation and the last follow-up was 25. 04 ± 5. 31,13. 37 ± 2. 81 and 11. 53 ± 7. 01,respectively; the NDI scores at the time points of one month after operation and the last follow-up were significantly lower than those before treatment（ P〈0. 01）. There was no injury of esophagus,nerve and blood vessel in all patients. There was no bucking,dysphagia,fixator shifting and screw loosening or breakage after operation. The intervertebral fusion rate was 100. 0%.Conclusion The short-term effect of Zero-profile interbody fusion device in the treatment of cervical spondylosis was satisfactory with simple operation,reliable fusion and low incidence of postoperative dysphagia.