零切迹椎间融合器用于单节段ACDF的中期疗效

Application of zero-profile interbody fusion cage in single-level ACDF: mid-term efficacy

目的评价零切迹颈椎间融合器在单节段颈椎前路椎间盘切除减压融合术(ACDF)中的应用价值。方法回顾性分析2017年1月至6月广州市中医医院收治的22例行ACDF的颈椎间盘突出症患者的临床资料,术中均采用Poster零切迹颈椎间融合器。记录手术前后视觉模拟量表(VAS)评分和日本骨科学会(JOA)评分,观察随访期间并发症发生情况。结果平均手术时间(75.3±15.3)min,术中出血量(18.2±12.0)mL,住院时间(9.2±3.5)d。随访时间24~31个月,平均随访时间26.4个月。术后2 d、6个月及末次随访VAS评分均较术前下降,JOA评分均高于术前,手术前后比较,差异有统计学意义(P<0.05)。术后6个月复查CT,所有患者均骨性融合。随访期间未见融合器松动移位、异位骨化、吞咽困难并发症,1例术后24个月发生邻近节段退变。结论在单节段ACDF术中应用零切迹颈椎间融合器,可改善患者颈椎功能,缓解疼痛症状,术后并发症少,且不增加邻近节段退变发生率,中期疗效良好。

Objective To evaluate the application value of zero-profile interbody fusion cage in single segment anterior cervical discectomy and fusion(ACDF).Methods Clinical data of 22 patients with cervical disc herniation who treated by ACDF using Poster zero-profile interbody fusion cage from January to June 2017 in Guangzhou Hospital of Traditional Chinese Medicine were analyzed retrospectively.Visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA)score before and after the surgery were recorded,and the complications during the follow-up were observed.Results The average operation time was(75.3±15.3)min,intraoperative estimate blood loss was(18.2±12.0)mL,and hospitalization time was(9.2±3.5)d.The average follow-up time was 26.4 months(from 24 to 31 months).VAS score decreased and JOA score increased at 2 d,6 months postoperatively and at the latest follow-up respectively,when compared with those before the operation(P<0.05).CT scan showed bony fusion in all patients at 6 months follow-up postoperatively.During the follow-up,no complications such as fusion cage loosening or displacement,heterotopic ossification,dysphagia were found.One patient had adjacent segment degeneration(ASD)24 months after the operation.Conclusion The application of zero-profile interbody fusion cage in single segment ACDF can obtain good mid-term effects due to improving the cervical function,relieving the pain of patients and reducing postoperative complications without increasing the incidence of ASD.