可变角度零切迹椎间融合器治疗单节段颈椎病的近期疗效

Short term efficacy of variable angle Zero-P in treatment of single-segment cervical spondylosis

目的观察并分析可变角度零切迹椎间融合器(Zero-P VA)治疗单节段颈椎病的近期疗效。方法2017年5月—2019年3月,采用Zero-P VA行颈椎前路椎间盘切除融合术(ACDF)治疗单节段颈椎病患者82例。记录所有患者术前、术后3个月及末次随访时C^(2~7) Cobb角及手术节段Cobb角,采用日本骨科学会(JOA)评分评估神经功能,采用疼痛视觉模拟量表(VAS)评分评估颈部及上肢疼痛程度,采用Bazaz评分评估患者术后吞咽困难情况,观察影像学资料上螺钉和置入物的稳定性。结果所有手术顺利完成,所有患者随访18~24(20.6±2.6)个月。所有患者术后临床症状和神经功能改善满意,与术前相比,术后3个月及末次随访时C_(2-7) Cobb角和手术节段Cobb角增大,JOA评分增高,VAS评分降低,差异均有统计学意义(P<0.05)。所有患者术后均未发生吞咽困难。至末次随访时,所有患者均未出现螺钉松动,融合器滑脱、松动或沉降。结论ACDF术中采用Zero-P VA治疗单节段颈椎病的近期临床疗效满意。

Objective To observe and analyze the short-term efficacy of variable angle Zero-P(Zero-P VA)in the treatment of single-segment cervical spondylosis.Methods From May 2017 to March 2019,82 patients with single-segment cervical spondylosis were treated with anterior cervical discectomy and fusion(ACDF)with Zero-P VA.C^(2-7) Cobb angle and operative segment Cobb angle were used to assess cervical curvature;Japanese Orthopaedic Association(JOA)score was used to evaluate the neurological function;visual analogue scale(VAS)score was used to evaluate neck and upper limb pain;Bazaz dysphagia score was used to evaluate postoperative dysphagia;imaging observation was used to evaluate the stability of screws and implants before operation,3 months after operation and at the final follow up.Results All the operations were successfully completed.All the patients were followed up for 18-24(20.6±2.6)months.All the patients achieved satisfactory improvement of clinical symptoms and neurological function.Compared with pre-operation,the C_(2-7) Cobb angle and operative segment Cobb angle increased,JOA score increased,and VAS score decreased at 3 months after operation and the final follow-up,all with a statistical significance(P<0.05).No dysphagia occurred after operation.Screw loosening,implant slippage,loosening and settlement displacement were not found in all the patients during the final follow-up.Conclusion The short-term clinical effect of Zero-P VA in ACDF for the treatment of single-segment cervical spondylosis is satisfactory.