应用Zero-P行颈前路椎间融合术治疗外伤性颈椎椎间盘突出并脊髓损伤

目的比较应用Zero-P和钛板并Cage行颈前路椎间融合术治疗外伤性颈椎椎间盘突出并脊髓损伤的临床疗效。方法回顾性分析本院2012年2月—2015年11月收治的78例外伤性颈椎椎间盘突出并脊髓损伤患者临床资料。其中38例行前路椎间盘切除、钛板并Cage内固定融合(Cage组),40例应用Zero-P行颈前路椎间融合术(Zero-P组)。比较2组患者术前及术后随访期间Frankel分级、颈椎曲度、椎间融合率、吞咽困难发生率等情况。结果所有患者随访12~37(15.76±3.80)个月。2组患者术后Frankel分级均较术前明显改善,差异有统计学意义(P0.05),2组间比较差异无统计学意义(P0.05)。2组术后颈椎曲度均较术前明显改善,与术前相比差异有统计学意义(P0.05),2组间比较差异无统计学意义(P0.05),且至末次随访时颈椎曲度无丢失。术后3个月,Zero-P组融合率高于Cage组,吞咽困难发生率显著低于Cage组,差异有统计学意义(P0.05)。末次随访时2组融合率差异无统计学意义(P0.05)。结论传统钛板并Cage内固定融合术与应用Zero-P行椎间融合术治疗外伤性颈椎椎间盘突出并脊髓损伤均可显著改善患者脊髓功能,但Zero-P具有术后早期即可获得较高融合率及术后吞咽困难发生率低的优点。

Anterior cervical interbody fusion with Zero-P for treatment of traumatic cervical disc herniation with spinal cord injury

Objective To compare the clinical efficacy of anterior cervical interbody fusion with Zero-P and titanium plate combined with Cage in the treatment of traumatic cervical disc herniation (TCDH) with spinal cord injury. Methods The clinical data of 78 TCDH patients with spinal cord injury from February 2012 to November 2015 were retrospectively analyzed. Thirty-eight patients were treated by anterior cervical discectomy and Cage plate internal fixation and fusion(Cage group),and the other 40 by anterior cervical interbody fusion with Zero-P internal fixator(Zero-P group). Frankel classification,cervical curvature,intervertebral fusion rate and the occurrence of dysphagia were compared between the 2 groups before operation and postoperative follow-up period. Results All the patients were followed up for 12-37(15.76±3.80)months. The Frankel classification was significantly improved compared with the preoperation in the 2 groups,and the difference was statistically significant(P < 0.05);but there was no significant difference between the 2 groups(P > 0.05). The cervical curvature was also significantly improved compared with pre-operation in the 2 groups,and the difference was statistically significant(P < 0.05); but there was no significant difference between the 2 groups(P > 0.05); and there was no loss of the curvature until the final follow-up. Postoperative 3 months,the fusion rate of Zero-P group was higher than that of Cage group,and the incidence of dysphagia was significantly lower than that in Cage group; the difference was statistically significant(P < 0.05). There was no significant difference in fusion rate between the 2 groups at the final follow-up(P > 0.05). Conclusion Anterior cervical interbody fusion with Zero-P and titanium plate combined with Cage are effective treatments for TCDH with spinal cord injury,but the Zero-P internal fixator has advantages of high fusion rate at early post-operation and a lower dysphagia incidence.