颈前路带插片的融合器治疗颈椎病的早期疗效分析

目的:探讨颈前路带插片的融合器治疗颈椎病的早期疗效分析?方法:回顾性分析2013年5月—2015年1月于本院行颈前路椎间盘切除减压带插片融合器(ROI-C型和MC+型)固定融合手术的47例颈椎病患者的早期疗效?ROI-C型融合器治疗23例,MC+融合器治疗24例?观察术前?术后3 d?术后3个月?末次随访时日本骨科协会(Japanese Orthopedic Association,JOA)评分?颈椎生理曲度?平均椎间高度?吞咽困难情况?3个月植骨融合率?出血量?手术时间?手术费用?住院时间? 结果:所有患者手术顺利,平均随访时间(11.3 ± 4.5)个月,一般情况良好,术后3个月和末次随访时JOA评分均较术前明显提高,差异有统计学意义?两种融合器术后颈椎生理曲度明显恢复,术后各时间点颈椎生理曲度较术前差异均有统计学意义,但两种融合器之间并未观察到统计学差异?术后各时间点平均椎间高度较术前明显增高?内植物下沉主要发生在早期,晚期也存在内植物下沉,但下沉距离小于早期下沉?术后有4例出现吞咽困难,术后7 d吞咽困难症状完全消失,随访时未再出现吞咽困难症状?术后3 d椎前软组织影厚度较术前差异有统计学意义,而术后3个月差异已无统计学意义?结论:带插片的颈椎融合器操作简便?手术时间短?术中出血少?术后恢复快?临床疗效满意,是用于颈椎前路手术治疗颈椎病的一种理想方法?

Analysis of early-stage clinical results of ROI-C and MC+ fusion cage used in anterior cervical operation

Objective: To explore the early-stage clinical results of ROI-C and MC+ fusion cage for patients treated by anterior cervical discectomy and fusion. Methods: Forty seven patients suffered from cervical spondylosis were treated by the same orthopedist with anterior cervical surgery (23 treated by ROT-C+ and 24 treated by MC(+) from May 2013 to Jan 2015). The evaluation indexes included Japanese Orthopaedic Association (JOA) scores,cervical physiological curvature,post-operative dysphagia,rate of bone fusion,intraoperative blood loss,duration of operation and costs of operation,duration of hospitalization were detected before suragury,postoperation 3 d,postoperation 3 month and the last follow-up respectively. Results: JOA scores of patients used ROI-C and MC+ at three-month post operation and the last follow-up were better than JOA scores of pre-opertaion,and the differences were statistically significant. Cervical physiological curvature of patients used ROI-C and MC+ at each follow-up time point was better than that of pre-operation. Average vertebral height at each follow-up time point was higher than that of pre-operation, the differences were statistically significant, but there were no statistical significances observed between ROI-C and MC+. Only 4 patients with dysphagia in 3 day post-operation, and dysphagia was disappeared in 7-day post-operation. Anterior vertebral soft tissue at 3-day was thicker than that at pre-operation (P < 0.05), there were no statistical significances between pre-operation and last follow-up. Conclusion: The ROI-C and MC+ fusion cage is a new kind of cage with less intraoperative blood loss, duration of operation and easy to operate.