颈椎零切迹融合器结合同种异体骨治疗颈椎病的临床疗效分析

Analysis of clinical effects of anterior cervical fusion cage fixation system zero profile with cancellous allogenic bone in the treatment of cervical spondylosis

目的探讨在颈椎病的手术治疗中填充同种异体松质骨的颈椎零切迹融合器的临床疗效。方法 2016年3月至2019年3月,对19例颈椎病患者进行颈前路椎间盘切除植骨融合术(ACDF),融合系统为填充同种异体松质骨的颈椎零切迹融合器。其中,男11例,女8例,年龄46~76岁,平均(61.3±2.1)岁。观察患者术后是否出现伤口感染、脑脊液漏及食管漏、声音嘶哑、饮水呛咳及吞咽困难,以及评估椎间融合情况,并对术前、术后1周与6个月的VAS评分及JOA评分进行评定,以确定手术疗效。结果所有患者均获得随访,随访时间为6~12个月,平均(10.2±1.5)个月。手术时间45~120 min,平均(64.3±4.9)min;术中出血量为45~120 m L,平均(66.5±4.6)mL;VAS评分及JOA评分显示术后较术前有明显的改善(P<0.05);术后未出现伤口感染、脑脊液漏、气管食管损伤、声音嘶哑、饮水呛咳等喉返神经损伤并发症发生。2例患者出现吞咽时疼痛,对进食稍有影响,其症状在术后2周内逐渐消失。未发现融合器移位、沉降、松动、断裂等情况。结论应用填充同种异体松质骨的颈椎零切迹融合器治疗颈椎病具有操作简单,疗效好,吞咽困难发生率低,并发症少。

Objective To explore the clinical efficacy of anterior cervical fusion cage fixation system zero profile with cancellous allogenic bone in the treatment of cervical spondylosis. Methods From March 2016 to March 2019, anterior cervical discectomy and fusion operation was used to treat 19 patients with cervical spondylosis, the fusion and fixation system was anterior cervical fusion cage fixation system zero profile with cancellous allogenic bone. There were 11 males and 8 females, aged from 46 to 76 years old, with an average age of(61.3±2.1) years. The patients’ postoperative intervertebral fusion rate, as well as the incidence of wound infection, leakage of cerebrospinal, hoarseness, choking and dysphagia were observed to assess the efficacy of operation. The postoperative 1 week, six months and the preoperative VAS and JOA score were used to assess the efficacy of operation. Results All patients were followed up for 6-12 months, with an average of(10.2±1.5) months. The operation time was 45-120 min, averageing(64.3±4.9) min.The intraoperative bleeding was 45-120 mL, averaging(66.5±4.6) mL. The VAS and JOA scores showed significant improvement after operation(P<0.05). There was no complications such as wound infection, leakage of cerebrospinal,tracheo-asophageal injury or recurrent laryngeal nerve damage. Two patients suffered from the swallowing difficult postoperative and were cured postoperative 2 weeks. During the follow up,there were no complications such as fixator migration, subsidence, loosening, breakage. Conclusion The anterior cervical fusion cage fixation system zero profile with cancellous allogenic bone in the treatment of cervical spondylosis, the operation is simple, the postoperative clinical effect is good, dysphagia occurs with low and less complications.