颈椎前路减压椎间融合术治疗单节段颈椎病:不应用钢板内固定的可行性分析

Anterior cervical decompression and interbody fusionin treatment of single-segment cervical spondylosis:feasibility analysis without use of steel plate internal fixation

目的比较颈椎前路椎间盘切除+PEEK-Cage植骨融合术+钢板内固定术与颈椎前路椎间盘切除+PEEK-Cage植骨融合术治疗单节段颈椎病的疗效。方法对2013年2月-2017年2月行颈椎前路减压椎间融合术的单节段颈椎病共86例进行回顾性分析,按照不同手术方式分为两组,A组共48例患者,行颈椎前路椎间盘切除+PEEK-Cage植骨融合术+钢板内固定术;B组共38例患者,行颈椎前路椎间盘切除+PEEK-Cage植骨融合术。根据手术情况、症状改善情况及影像学资料对两组患者作分析比较。结果两组术后1周及末次随访时的JOA评分、VAS评分及融合节段Cobb角均较术前显著改善(P<0.001),颈椎曲度(C 2-7 Cobb角)与术前相比无显著性差异(P>0.05)。两组的手术时间与术中出血量比较,无显著性差异(P>0.05);术后及随访过程中,两组融合节段Cobb角、颈椎曲度、椎间融合高度变化的差异无统计学意义(P>0.05)。结论单纯应用颈椎前路椎间盘切除+PEEK-Cage植骨融合术治疗单节段颈椎病,出血少,手术时间短,并发症少,可以获得满意的临床疗效。

Objective To compare the efficacy of anterior cervical discectomy+PEEK-Cage bone grafting+rigid plate internal fixation(group A)and cervical anterior discectomy+PEEK-Cage bone grafting(group B)in the treatment of single-segment cervical spondylosis.Methods The clinical data of 86 patients with single-segment cervical spondylosis who underwent anterior cervical decompression and interbody fusion from February 2013 to February 2017 were retrospectively analyzed.The patients were divided into two groups according to different surgical methods.The 48 patients in group A that received anterior cervical discectomy+PEEK-Cage bone graft fusion+plate internal fixation;38 patients in group B received anterior cervical discectomy+PEEK-Cage bone graft fusion.The operation status,symptom improvement and imaging data of the two groups were analysed and compared.Results The JOA score,VAS score and fusion segment Cobb angle measured 1 week after operation and in the last follow-up were ameliorated,and the differences were statistically significant compared with preoperative(P<0.001).Cervical curvature(C 2-7 Cobb angle)showed no significant difference compared with preoperative(P>0.05).There was no significant difference in operation time,intraoperative blood loss between the two groups(P>0.05).No significant differences were detected in the changes in Cobb angle,cervical curvature and intervertebral fusion height between the two groups postoperatively and during the follow-up(P>0.05).Conclusion Anterior cervical discectomy PEEK-Cage bone graft fusion can be used to treat single-segment cervical spondylosis,with less bleeding,short operation time,fewer complications,and satisfactory clinical results can be obtained.