本文選題：頸椎病 + 頸前路減壓植骨融合術(shù)�。� 參考：《中國骨與關(guān)節(jié)損傷雜志》2016年09期

【摘要】：目的比較頸前路減壓鈦板聯(lián)合cage植骨融合內(nèi)固定與零切跡椎間融合治療單節(jié)段頸椎病術(shù)后對(duì)鄰近節(jié)段退變的影響。方法回顧性分析自2009-06—2013-05采用頸前路減壓鈦板聯(lián)合cage融合內(nèi)固定(鈦板組)及頸前路減壓零切跡椎間植骨融合內(nèi)固定術(shù)(零切跡組)治療的49例頸椎病,鈦板組24例,零切跡組25例。比較2組手術(shù)時(shí)間、術(shù)中出血量、NDI指數(shù)、JOA評(píng)分、Bazaz吞咽困難分級(jí),測(cè)量頸椎曲度、相鄰椎體角度位移及水平位移。結(jié)果 2組手術(shù)時(shí)間(t=0.789,P=0.347)、術(shù)中出血量(t=1.488,P=0.303)比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。49例均獲得隨訪24~60個(gè)月,平均37.8個(gè)月。零切跡組吞咽困難發(fā)生例數(shù)少于鈦板組,差異有統(tǒng)計(jì)學(xué)意義(χ~2=3.984,P=0.043)。術(shù)后6個(gè)月、末次隨訪時(shí)的NDI指數(shù)及JOA評(píng)分均較術(shù)前明顯改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2組術(shù)后6個(gè)月及末次隨訪時(shí)頸椎曲度比較差異無統(tǒng)計(jì)學(xué)意義(P0.05);但鈦板組術(shù)后6個(gè)月及末次隨訪時(shí)角度位移和水平位移均大于零切跡組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論頸前路減壓鈦板聯(lián)合cage融合內(nèi)固定與零切跡融合均能良好地改善臨床癥狀和維持頸椎曲度,在減少吞咽困難、相鄰椎體角度位移及水平位移方面,零切跡系統(tǒng)具有一定優(yōu)勢(shì)。
[Abstract]:Objective to compare the effect of anterior cervical decompression and titanium plate combined with cage bone grafting and internal fixation and zero notch intervertebral fusion on adjacent segment degeneration after single segment cervical spondylosis. Methods 49 cases of cervical spondylopathy treated with anterior cervical decompression combined with cage fusion and internal fixation (titanium plate group) and anterior cervical decompression with zero notch fusion and internal fixation (zero notch group) were retrospectively analyzed. 24 cases in titanium plate group were treated with cervical spondylopathy. Zero notch group 25 cases. The operative time, NDI index and Bazaz's dysphagia grade were compared between the two groups. The cervical curvature, angle displacement and horizontal displacement of adjacent vertebrae were measured. Results there was no significant difference in the operative time between the two groups (P 0.05, P 0.05, P 0.05) and the average of 37.8 months (mean, 37.8 months). The incidence of dysphagia in the zero notch group was less than that in the titanium plate group, and the difference was statistically significant (蠂 2 + 3.984). After 6 months, the NDI index and JOA score were significantly improved at the last follow-up. There was no significant difference in cervical curvature at 6 months after operation and at the last follow-up, but the angle displacement and horizontal displacement in the titanium plate group were higher than those in the zero notch group at 6 months after operation and at the last follow-up, and the difference was statistically significant (P 0.05). Conclusion anterior cervical decompression titanium plate combined with cage fusion internal fixation and zero notch fusion can improve clinical symptoms and maintain cervical curvature, and reduce dysphagia, angle displacement and horizontal displacement of adjacent vertebrae. Zero notch system has some advantages.
【作者單位】： 寶雞市中醫(yī)醫(yī)院骨科;
【基金】：陜西省衛(wèi)生廳科研基金項(xiàng)目(2012C5)
【分類號(hào)】：R687.32

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