两种材质的融合器在颈前路椎间盘切除融合术中应用的比较研究

Comparative study on application of two kinds of fusion cages in anterior cervical discectomy and fusion

目的 比较纳米羟基磷灰石/聚酰胺66和聚醚醚酮两种不同材质的椎间融合器在颈椎间盘切除融合内固定术中应用的疗效差异。方法 将林州仁济医院2016年3月—2018年5月行颈前路椎间盘切除融合术治疗的90例单节段颈椎病随机分为2组,45例采用纳米羟基磷灰石/聚酰胺66融合器(A组),45例采用聚醚醚酮融合器(B组)。对两组患者术前及末次随访的影像学(C_(2-7)颈椎曲度、节段Cobb角、融合节段高度,植骨融合情况和cage下沉率)和临床疗效参数(VAS评分、JOA评分)进行比较。结果 两组患者随访资料齐全,其中A组随访时间为(21.1±4.3)个月,B组随访时间为(22.2±4.7)个月,差异无统计学意义(P>0.05)。两组在最终随访时发现椎间均融合,两组在VAS评分、JOA评分、融合器的下沉率、C颈椎曲度、节段Cobb角及融合节段高度等方面的差异均无统计学意义(P>0.05)。随访过程中没发现吞咽困难、钛板移位、声音嘶哑。结论 采用纳米羟基磷灰石/聚酰胺66融合器治疗单节段颈椎病和聚醚醚酮融合器的疗效相当,影像学结果一致。

Objective To compare the efficacy of two different materials of nano-hydroxyapatite/polyamine 66 and polyetheretherketone in cervical discectomy, fusion and internal fixation.Methods Totally 90 cases of single-segment cervical spondylosis treated with anterior cervical discectomy and fusion from March 2016 to May 2018 in our hospital were randomly divided into two groups, 45 cases were treated with n-HA/PA66 Cage(A group),and 45 cases were treated with PEEK Cage(B group).The groups were compared regarding radiographic(C_(2-7)cervical curvature, segmental Cobb angle, fused segments height, bone fusion and cage subsidence) and clinical efficacy(VAS score and JOA score,) parameters preoperatively and at the final follow-up.Results The follow-up data of the two groups of patients were complete.The follow-up time of group A was(21.1±4.3) months, and the follow-up time of group B was(22.2±4.7) months.The difference was not statistically significant(P>0.05).Both groups were found to be fused at the final follow-up.There was no Statistically significant differences between the two groups in VAS score, JOA score, cage subsidence, Ccervical curvature, segment Cobb angle, and fused segments height(P>0.05).No complication, such as dysphagia or titanium plate displacement or hoarseness, occurred during the follow-up.Conclusion The therapeutic effects of n-HA/PA66 Cage for single-segment cervical spondylosis are equivalent to PEEK Cage, and the imaging results are consistent.