摘要
目的比较颈前路减压植骨融合Zero-P钢板与传统钢板内固定治疗单节段颈椎病的临床疗效。方法回顾性分析自2010-01—2013-04行颈前路减压植骨融合内固定术治疗的51例单节段颈椎病,24例术中采用Zero-P钢板(观察组),27例术中采用传统钢板与椎间融合器(对照组)。比较2组术后疼痛VAS评分(神经根型颈椎病)、JOA评分(脊髓型颈椎病)、NDI指数、颈椎Cobb角、吞咽困难Bazaz等级、植骨融合Eck等级、邻近节段退变发生率。结果 51例均获得随访,观察组随访(81.0±4.4)个月,对照组随访(79.0±3.4)个月。观察组术后1、6个月吞咽困难Bazaz分级优于对照组,差异有统计学意义(P <0.05);但2组术后12个月吞咽困难Bazaz分级差异无统计学意义(P>0.05)。2组术后邻近节段退变发生率、术后12个月植骨融合Eck分级差异无统计学意义(P>0.05)。观察组与对照组术后1个月、12个月及末次随访时JOA评分、疼痛VAS评分、NDI指数、颈椎Cobb角比较差异无统计学意义(P>0.05)。结论颈前路减压植骨融合内固定治疗单节段颈椎病术中应用Zero-P钢板在减轻患者术后早期吞咽困难症状方面较传统颈前路钢板固定具有优势,但这两种手术方式在维持颈椎生理曲度、缓解临床症状、植骨愈合、邻近节段退变发生率方面并无明显差异。
Objective To compare the clinical effect of anterior cervical decompression and fusion with Zero-P plate and traditional plate internal fixation for single-segment cervical spondylosis.Methods Fifty-one cases of single-segment cervical spondylosis treated with anterior decompression and bone graft fusion internal fixation were enrolled from January2010 to April 2013.Zero-P plate(observation group)was used in 24 cases,and traditional plate and interbody fusion device(control group)were used in 27 cases.The pain VAS score(cervical spondylotic radiculopathy),JOA score(spinal cervical spondylosis),NDI index,cervical Cobb angle,dysphagia Bazaz grade,bone graft fusion Eck grade,and incidence of degeneration of adjacent segments were compared between two groups.Results Fifty-one patients were followed up.The observation group was followed up for(81.0±4.4)months,and the control group was followed up for(79.0±3.4)months.The Bazaz classification of dysphagia in the observation group at 1 and 6 months after operation was better than that in the control group,the difference was statistically significant(P<0.05);but the Bazaz classification of dysphagia at 12 months after operation in the two groups was not statistically significant(P>0.05).There was no significant difference in the incidence of adjacent segmental degeneration and the Eck classification of bone graft fusion at 12 months after operation in the two groups(P>0.05).There was no significant difference in the JOA score,pain VAS score,NDI index,and cervical Cobb angle between the observation group and the control group at 1 month,12 months,and at the last follow-up(P>0.05).Conclusion Anterior decompression and bone graft fusion internal fixation for the treatment of single-segment cervical spondylosis with Zero-P plate has advantages over traditional anterior cervical plate fixation in reducing the symptoms of early swallowing difficulties in patients after surgery.There are no significant differences in the maintenance of cervical physiological curvature,relief of clinical symptoms,bone graft healing,and incidence of adjacent segment degeneration.
作者
黎一兵
高文杰
杨小卫
王晓东
郝定均
LI Yi-bing;GAO Wen-jie;YANG Xiao-wei;WANG Xiao-dong;HAO Ding-jun(Department of Spinal Surgery,Xi'an Red Cross Hospital,Xi'an,Shcumxi 710054,China)
出处
《中国骨与关节损伤杂志》
2020年第3期225-228,共4页
Chinese Journal of Bone and Joint Injury
基金
陕西省自然科学基金(2017JQ8056
2017JM8115)
陕西省博士后科学基金(2017BSHQYXMZZ15)。
关键词
单节段颈椎病
颈前路减压植骨融合内固定术
邻近节段退变
Zero-P钢板
Single-level cervical pathology
Anterior decompression and bone graft fusion internal fixation
Adjacent segment degeneration
Zero-P plate
