摘要
目的系统评估和比较零切迹椎间融合固定器Zero-P和颈前路钢板固定的单节段颈椎前路椎间盘切除融合术后患者吞咽功能情况。方法经过标准的纳入标准和排除标准筛选2013-09-2015-09在我院行单节段颈椎前路椎间盘切除融合术且应用Zero-P或传统颈椎前路钢板的患者,根据标准的Bazaz吞咽功能评分量表对患者术后1周、1个月、3个月、6个月、1年的吞咽情况进行电话随访评估,比较2组患者术后吞咽困难发生率和吞咽困难程度,采用SPSS 19.0统计软件进行统计分析,P<0.05认为有统计学意义。结果共筛选出2013-09-2015-09在我院行单节段颈椎前路椎间盘切除融合术患者164例,其中Zero-P组80例,钢板组84例,所有患者均完成了至少12个月以上随访进行吞咽困难评估。Zero-P组和钢板组在术后1周、术后1个月、术后3个月、术后6个月、术后1年总吞咽困难发生率分别为:27.50%和42.86%、18.75%和33.33%、11.25%和23.81%、8.75%和20.24%、6.25%和16.67%,根据非参数检验(Mann Whitney U test)结果显示,Zero-P组患者吞咽困难发生率和严重程度在术后历次随访时间点均低于钢板组,P<0.05。结论和传统的颈椎前路钢板相比,零切迹椎间融合固定器Zero-P能降低单节段颈椎前路椎间盘切除融合术患者术后吞咽困难的发生率和严重程度,大部分吞咽困难患者为轻度和中度吞咽困难,重度吞咽困难不常见,并且随着随访时间延长,大部分患者吞咽困难症状将得到自发缓解。
Objective To compare the incidence and severity of post-operative dysphagia between anterior cervical discectomy and fusion （ACDF） with the Zero-P implant system and ACDF with a traditional anterior plate. Methods According to the standard inclusion criteria and exclusion criteria, patients who underwent single segment ACDF using Zero-P or a traditional anterior plate between September 2013 and September 2015 in our hospital were retrospectively evaluated regarding dysphagia. Dysphagia was assessed according to the Bazaz grading system （0-none; 1-mild; 2- moderate; 3-severe） at 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively, The statistical program SPSS 19.0 was used for performing statistical analysis. Statistical significance was accepted at a probability value of less than 0.05. Results A total of 164 patients （Zero-P group 80 patients and plate group 84 patients） were included at last. All the patients completed a follow-up of at least 12 months. The total incidence rates of postoperative dysphagia in Zero-P group and plate group were 27.50% and 42.86%, 18.75% and 33.33%, 11.25% and 23.81%, 8.75% and 20.24%, 6.25% and 16.67%. Results from the nonparametric test （Mann-Whitney U test） showed that the incidence of dysphagia and severity of dysphagia in Zero-P group was lower than plate group at each follow-up point（all P〈0.05）. Conclusion Compared with anterior cervical plating, ACDF with Zero-P can significantly reduce the incidence of postoperative transient and persistent dysphagia and the severity of dysphagia. Most of the dysphagia was mild and gradually decreased during the following months. Severe dysphagia was not common.
出处
《颈腰痛杂志》
2017年第6期568-572,共5页
The Journal of Cervicodynia and Lumbodynia
