摘要
目的 比较颈椎零切迹椎间融合器与传统颈前路减压植骨融合内固定(ACDF)手术治疗颈椎病的疗效。方法 选取2017年5月至2021年4月在遂宁市中心医院脊柱外科接受手术治疗的116例单节段脊髓型颈椎病患者作为研究对象,采用随机数字表法将患者分为研究组和对照组各58例,研究组患者采用颈前路颈椎零切迹椎间融合器实施手术治疗,对照组患者采用传统ACDF手术实施治疗。比较两组患者的手术时间、出血量、住院时间;比较两组患者手术前后的影像学参数(椎间隙高度、Cobb角、颈椎曲度指数)、视觉模拟疼痛评分(VAS)、日本骨科协会(JOA)评分及手术并发症发生率。结果 研究组手术时间少于对照组(P<0.05),两组患者出血量、住院时间无明显差异(P>0.05)。两组患者术前、术后3个月、术后6个月的椎间隙高度、Cobb角、颈椎曲度指数均无明显差异(P>0.05);术后3个月、6个月,两组患者的椎间隙高度、Cobb角、颈椎曲度指数均较术前显著升高(P<0.05)。两组患者术前VAS评分、JOA评分无显著差异(P>0.05);术后3个月、术后6个月研究组患者JOA评分均高于对照组(P<0.05),VAS评分两组间无差异(P>0.05);术后3个月和6个月,两组患者的VAS评分均较术前降低(P<0.05),JOA评分均较术前升高(P<0.05);研究组患者术后发生并发症3例(5.17%),对照组患者术后发生并发症6例(10.34%),两组间无统计学差异(P>0.05)。结论 颈椎零切迹椎间融合器与传统ACDF手术治疗单节段脊髓型颈椎病均能取得较好的临床效果,颈椎零切迹椎间融合器治疗方式能取得更好的恢复效果。
Objective To compare and analyze the effect of a cervical zero-notch interbody cage and traditional anterior cervical decompression,bone grafting,fusion and internal fixation(ACDF)for the treatment of cervical spondylosis.Methods One hundred and sixteen patients with single-segment cervical spondylotic myelopathy who underwent surgical treatment at the Spinal Surgery Department of Suining Central Hospital from May 2017 to April 2021 were selected as the research subjects.The patients were randomly divided into a study group and a control group,consisting of 58 patients each,using a random number table method.The study group patients were treated using an anterior cervical zero notch intervertebral fusion cage,while control group patients were treated by traditional anterior cervical decompression,bone graft fusion,and internal fixation.We compared the surgical time,bleeding volume,and hospital stay between the two groups of patients,as well as the imaging parameters(intervertebral height,Cobb angle,cervical curvature index),visual analog scale(VAS)pain score,Japanese Orthopedic Association(JOA)score before and after surgery,and surgical complication rate between the two groups of patients.Results The surgical time in the study group was shorter than that in the control group(P<0.05),and there was no significant difference in bleeding volume and hospital stay between the two groups(P>0.05).There was no significant difference in intervertebral space height,Cobb angle,or cervical curvature index between the two groups of patients before surgery,3 months after surgery,or 6 months after surgery(P>0.05).At 3 and 6 months after surgery,the intervertebral height,Cobb angle,and cervical curvature index of both groups of patients were significantly increased compared to before surgery(P<0.05).There was no significant difference in preoperative VAS score or JOA score between the two groups of patients(P>0.05);however,the JOA scores of patients in the study group were significantly higher than those in the control group at 3 months and 6 months after surgery(P<0.05),while the VAS scores were lower(P<0.05).There were three cases(5.17%)of postoperative complications in the study group patients,and six cases(10.34%)among the control group patients;however,there was no statistically-significant difference between the two groups(P>0.05).Conclusion Both the cervical zero notch intervertebral fusion device and the traditional ACDF surgery for single-segment cervical spondylosis can achieve good clinical results,but the cervical zero notch intervertebral fusion device can achieve a better recovery effect.
作者
汪凡栋
郑佳状
陈宇
宋昭君
刘元彬
唐龙
王淼
WANG Fandong;ZHENG Jiazhuang;CHEN Yu;SONG Zhaojun;LIU Yuanbin;TANG Long;WANG Miao(Department of Orthopedics,Suining Central Hospital,Suining 629000,China)
出处
《国际骨科学杂志》
2023年第5期321-326,共6页
International Journal of Orthopaedics
基金
四川省医学会骨科专项科研课题(2020SAT09)。
关键词
颈椎零切迹椎间融合器
颈前路减压植骨融合内固定手术
脊髓型颈椎病
日本骨科协会评分
Cervical spine zero-notch interbody cage
Anterior cervical decompression and internal fixation
Cervical spondylotic myelopathy
Japanese Orthopedic Association score
