颈椎前路减压cage与zero-p椎间植骨融合内固定治疗单节段脊髓型颈椎病的疗效比较

目的比较颈椎前路减压cage椎间植骨融合钛板内固定与zero-p椎间植骨融合内固定治疗单节段脊髓型颈椎病的临床疗效及并发症情况。方法纳入自2013-06—2015-06诊治的110例单节段脊髓型颈椎病,采用颈椎前路减压cage椎间植骨融合钛板内固定治疗55例(cage组),采用颈椎前路减压zero-p椎间植骨融合内固定治疗55例(zero-p组)。比较2组手术时间、术中出血量、住院时间,术后12个月JOA评分、NDI指数、颈椎曲度、颈椎节段高度及植骨融合率,术后1周、3个月吞咽困难发生例数。结果所有患者均获得(22.78±3.10)个月随访。2组手术时间、术中出血量、住院时间比较差异无统计学意义(P0.05)。2组术后12个月JOA评分、NDI指数、颈椎曲度、颈椎节段高度、植骨融合率差异无统计学意义(P0.05)。zero-p组术后1周、3个月吞咽困难发生例数少于cage组,差异有统计学意义(P0.05)。结论颈椎前路减压cage椎间植骨融合钛板内固定与zero-p椎间植骨融合内固定治疗单节段脊髓型颈椎病均可取得满意的临床疗效,但zero-p椎间植骨融合内固定术后吞咽困难发生的风险明显较低,其安全性更符合临床需要。

Clinical effect comparison of anterior cervical decompression separately combined with cage and zero-p interbody fusion internal fixation in treatment of cervical spondylotic myelopathy for single segment

Objective To investigate the clinical effects and complications of anterior cervical decompression separately combined with cage and zero-p interbody fusion internal fixation in the treatment of cervical spondylotic myelopathy for single segment.Methods One hundred and ten patients with single segment cervical spondylosis from June 2013 to June 2015 were chosen and randomly divided into cage group (55 patients) with internal fixation of titanium plate combined with fusion and zero-p group (55 patients) with internal fixation scheme of anterior decompression and zero-p interbody fusion.The perioperative clinical indicators,the JOA score,NDI score,cervical curvature and cervical segmental height in 12 months after operation,graft bone fusion rate and the dysphagia incidence in 1 week and 3 months after operation of both groups were compared.Results All patients were followed up for (22.78±3.10)months.There was no significant difference in the operation time,intraoperative volume and hospital staying time between 2 groups (P ＞0.05).There was no significant difference in the JOA score,NDI score,cervical curvature and cervical segmental height in 12 months after operation and graft bone fusion rate between 2 groups(P ＞0.05).The dysphagia incidence after operation in zero-p group was significantly lower than that in cage group (P ＜0.05).Conclusion Anterior cervical decompression separately combined with cage and zero-p interbody fusion internal fixation in the treatment of cervical spondylotic myelopathy for single segment possess the same excellent clinical effects;but anterior decompression,zero-p interbody fusion internal fixation application can efficiently reduce the risk of postoperative dysphagia and its safety should be more suitable for clinical needs.