两种融合器在颈椎前路椎间盘切除融合术治疗双节段颈椎病中的应用比较OA
Application comparison of two fusion devices in anterior cervical discectomy and fusion for two-level cervical spondylosis
目的 比较颈椎前路椎间盘切除融合术(ACDF)中使用零切迹椎间融合器(Zero-P)与传统钛板联合融合器(钛板+cage)治疗双节段颈椎病的效果.方法 将行ACDF治疗的80例相邻双节段颈椎病患者根据术中使用融合器的不同分为Zero-P组(术中使用Zero-P治疗,40例)和钛板+cage组(术中使用钛板+cage治疗,40例).比较两组手术情况、影像学指标、临床疗效指标.结果 患者均获得12个月随访.术中出血量、手术时间、住院时间Zero-P组均少(短)于钛板+cage组(P＜0.01).术后第3天吞咽困难程度Zero-P组低于钛板+cage组(P＜0.05).末次随访时,邻近节段退变率Zero-P组高于钛板+cage组,椎间融合率低于钛板+cage组,但两组比较差异均无统计学意义(P＞0.05);内置物下沉发生率Zero-P组高于钛板+cage组(P＜0.05).术后及末次随访时,NDI指数、疼痛VAS评分、JOA评分两组均较术前改善(P＜0.05),两组比较差异均无统计学意义(P＞0.05).结论 ACDF中使用Zero-P和钛板+cage治疗双节段颈椎病均可获得较好的疗效,钛板+cage可降低术后内置物下沉发生率;而Zero-P在围手术期指标的改善、降低术后短期吞咽困难发生率方面更有优势.
Objective To compare the efficacy of using the Zero-profile interbody fusion device(Zero-P)and the tra-ditional titanium plate combined with cage in anterior cervical discectomy and fusion(ACDF)for the treatment of two-level cervical spondylosis.Methods The 80 patients with adjacent two-level cervical spondylosis who underwent ACDF were divided into the Zero-P group(treated with Zero-P during the operation,40 cases)and the titanium plate and cage group(treated with titanium plate and cage during the operation,40 cases)based on the different fusion de-vices used during the operation.The surgical conditions,imaging indicators,and clinical efficacy indicators of the two groups were compared.Results All patients were followed up for 12 months.The intraoperative blood loss,op-eration time,and hospital stay in the Zero-P group were less(shorter)than those in the titanium plate and cage group(P＜0.01).The degree of dysphagia on the third day after surgery in the Zero-P group was lower than that in the ti-tanium plate and cage group(P＜0.05).At the last follow-up,the rate of adjacent segment degeneration in the Ze-ro-P group was higher than that in the titanium plate and cage group,and the interbody fusion rate in the Zero-P group was lower than that in the titanium plate and cage group,but the differences between the two groups were not statistically significant(P＞0.05);the incidence of implant subsidence in the Zero-P group was higher than that in the titanium plate and cage group(P＜0.05).At the postoperation and last follow-up,the NDI index,pain VAS,and JOA score of both groups improved,compared with those before the operation(P＜0.05),and there were no sta-tistically significant differences between the two groups(P＞0.05).Conclusions Both Zero-P and titanium plate and cage in ACDF can achieve better therapeutic effects for two-level cervical spondylosis.The titanium plate and cage can reduce the incidence of implant subsidence after surgery;while Zero-P has more advantages in improving periop-erative indicators and reducing the incidence of short-term dysphagia after surgery.
阚世虎;焦延亮;蓝中江;赵松夏荷;陈磊;杜怡斌
安徽医科大学第三附属医院脊柱外科,安徽 合肥 230061安徽医科大学第三附属医院脊柱外科,安徽 合肥 230061安徽医科大学第三附属医院脊柱外科,安徽 合肥 230061安徽医科大学第三附属医院脊柱外科,安徽 合肥 230061安徽医科大学第三附属医院脊柱外科,安徽 合肥 230061安徽医科大学第三附属医院脊柱外科,安徽 合肥 230061
医药卫生
零切迹椎间融合器传统钛板联合融合器相邻双节段颈椎病颈椎前路椎间盘切除融合术
Zero-profile interbody fusion devicethe traditional titanium plate combined with cageadjacent two-level cervical spondylosisanterior cervical discectomy and fusion
《临床骨科杂志》 2026 (4)
461-464,4
安徽省卫健委卫生健康科研项目(编号:AHWJ2022b113)
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