ROI-C与钢板联合cage在单节段脊髓型颈椎病ACDF术中应用的效果比较

A comparative study of effects between ROI-C interbody fusion cage and plate fixation combined cage in ACDF for single segment cervical spondylotic myelopathy

目的比较双嵌式椎间融合器(ROI-C)与钢板联合cage在单节段脊髓型颈椎病前路减压植骨融合内固定(ACDF)术中应用的临床效果。方法纳入自2013-03—2015-03诊治的39例单节段脊髓型颈椎病,21例采用ROI-C行ACDF术(ROI-C组),18例采用钢板联合cage行ACDF术(cage组)。比较2组手术时间、术中出血量,术后3 d、3个月、12个月手术间隙相邻椎间高度,末次随访时JOA评分,植骨融合及并发症情况。结果 39例均获得随访,ROI-C组随访时间为(13.3±1.9)个月,cage组随访时间为(14.9±1.7)个月。所有患者术后1年内植骨融合,均未发现融合器移位、变形。与cage组比较,ROI-C组手术时间更短,术中出血量更少,吞咽不适发生率明显更低,差异有统计学意义(P <0.05)。ROI-C组与cage组术后3 d、3个月、12个月手术间隙相邻椎间高度及末次随访时JOA评分比较差异无统计学意义(P>0.05)。结论 ROI-C系统在单节段脊髓型颈椎病手术治疗中应用具有稳定性好、创伤小、术后吞咽不适发生率低的优点。

Objective To compare the clinical effects of ROI-C interbody fusion cage and plate fixation combined cage in anterior cervical decompression and fusion （ACDF） for cervical spondylotic myelopathy. Methods Thirty rone ptients with cervical spondilotic myelopathy receiving ACDF from March 2013 to March 2015 were divided into ROI-C group （n =21） and plate fixation combined cage group （n =18）. The intraoperative blood loss, operation time, intervertebral heigt at 3 day, 3 months and 12 months after operation, the JOA scores, bone graft fusion rate and complications at last followup were compared between two groups. Results All patients were followed up. The average follow up was （13.3±1.9） month in ROI-C group and （14.9±1.7） month in plate fixation combined cage group. All patients achieved bone fusion within one year after operation, and no displacement or deformation occurred. In ROI-C group, the operation time, intraoperative blood loss and occurrence rate of swallowing discomfort were significantly lower than those in plate fixation combined cage group, the differences were statistically significant （P 〈0.05）. But there were no statistically significant differences in intervertebral height at 3 days, 3 months and 12 months after operation and the JOA score at last followup between two groups （P 〉0.05）. Conclusion The stability of ROI-C interbody fusion cage in treatment of single segment cervical spondylotic myelopathy is reliable. The surgery has less trauma and lower occurrence rate of swallowing discomfort.