颈椎前路零切迹椎间融合器与传统钛板联合融合器治疗脊髓型颈椎病的疗效比较

Comparison of the efficacy of anterior cervical ROI-C and traditional titanium plate fusion device for cervical spondylotic myelopathy

目的:比较分析新型颈椎前路零切迹椎间融合器(ROI-C)与传统钛板联合融合器在治疗脊髓型颈椎病中的临床疗效及影像学指标。方法:回顾性分析2014年1月~2018年12月因脊髓型颈椎病行颈椎前路手术的患者共56例,其中使用ROI-C 27例,使用传统钛板联合融合器29例。将两组患者的一般资料、手术融合节段、手术时间、术中出血量、临床预后评分、影像学指标及术后颈部异物感等并发症等进行比较。结果:术后平均随访时间(20.1±4.3)月,两组性别及年龄构成差异均无统计学意义(P>0.05)。两组手术融合节段组间差异无统计学意义(P>0.05)。ROI-C组手术时间(117.2±14.4)min及出血量(50.9±12.5)mL均低于钛板组[(141.9±19.2)min和(77.6±18.3)mL],差异有统计学意义(P<0.05)。两组术后日本骨科学会评估治疗分数(JOA)评分、颈椎功能障碍指数(NDI)评分、视觉模拟评分法(VAS)评分及术后椎间隙高度与颈椎曲度与术前相比差异均无统计学意义。术后颈部异物感发生率ROI-C组低于钛板组。结论:颈椎前路手术中应用ROI-C与传统钛板联合融合器疗效相近,但前者具有手术时间少、术中出血量低及术后颈部异物感发生率低等优点。

Objective:To compare the clinical efficacy and imaging indexes of anterior ROI-C■ cervical cage and the conventional titanium plate combined fusion cage in the treatment of patients with cervical spondylotic myelopathy.Methods:Retrospective analysis was performed in 56 patients with cervical spondylotic myelopathy undergone anterior cervical surgery in our hospital between January 2014 and December 2018.of the 56 patients,27 were treated with ROI-C■ cervical cage and 29 with conventional titanium plate combined fusion cage.The two groups of patients were compared regarding the demographical information,surgically fused segments,operative time,intraoperative blood loss,clinical prognostic scores,imaging indexes and postoperative complications such as dysphagia.Results:The mean follow-up was(20.1±4.3)months.The difference was insignificant in gender,age and surgically fused segments between groups(all P>0.05).The operative and intraoperative blood loss were shorter and lower in patients treated with ROI-C■ cervical cage than in those treated with conventional titanium plate combined fusion cage[(117.2±14.4)min vs.(141.9±19.2)min;(50.9±12.5)mL vs.(77.6±18.3)mL,respectively,both P<0.05].There were significant changes in JOA,Neck disability index(NDI),VAS scores,postoperative intervertebral space height and cervical curvature between the two groups compared to those indexes before surgery,yet there was no statistical difference between group.Patients treated with ROI-C■ cervical cage had lower incidence of postoperative dysphagia than those treated by conventional titanium plate combined with fusion device.Conclusion:The efficacy of ROI-C internal fixation system in anterior cervical surgery is similar to that of conventional titanium plate combined fusion cage system,whereas the former has the advantages of shortened operative time,lower intraoperative blood loss and incidence of postoperative dysphagia.