【摘要】：[目的]評價前路減壓Zero-p椎間融合器治療頸椎病臨床和影像學(xué)結(jié)果。[方法]回顧性分析2010年1月~2013年1月接受頸椎前路椎間盤切除融合術(shù)(anterior cervical discectomy and fusion,ACDF)聯(lián)合Zero-p椎間融合器固定治療頸椎病患者相關(guān)資料。臨床功能評估采用頸椎功能障礙指數(shù)(neck disability index,NDI)、疼痛視覺模擬評分(visual analogue scale,VAS),影像學(xué)評估采用頸椎正側(cè)位X線片,通過Cobb角測量方法,測量病變節(jié)段上下椎體Cobb角,測量C_(3~7)椎體頸前軟組織厚度,并于術(shù)后2年評估融合情況,吞咽困難等并發(fā)癥也被觀察。[結(jié)果]共納入45例患者(50個節(jié)段),27例男性和18例女性,平均年齡(45.64±6.28)歲。所有患者至少隨訪24個月,平均隨訪時間為(41.11±7.82)個月。患者術(shù)后NDI、VAS評分均較術(shù)前有明顯改善。影像學(xué)上94%的置入物融合。最終隨訪時頸椎前凸保持良好。術(shù)后頸前軟組織厚度較術(shù)前顯著增加,從平均(7.6±1.9)mm增至(15.2±2.9)mm,最終隨訪時(9.9±1.9)mm。按吞咽困難Bazaz分級,術(shù)后吞咽困難發(fā)生率44.4%,然而在最終的隨訪時仍有6.6%的患者具有輕、中度吞咽困難。在術(shù)后即刻和最終隨訪時頸前軟組織厚度和吞咽困難分級Pearson相關(guān)性分析表明二者呈顯著正相關(guān)。1例患者術(shù)后出現(xiàn)持續(xù)性的左上肢疼痛伴左三角肌肌力減弱,1例患者發(fā)生聲音嘶啞,隨訪3個月后完全恢復(fù)。[結(jié)論]頸前椎間盤切除融合術(shù)聯(lián)合Zero-p椎間融合器固定治療頸椎病可獲得較好的臨床和影像學(xué)結(jié)果,術(shù)后吞咽困難發(fā)生與頸前軟組織厚度呈顯著正相關(guān)。
[Abstract]:Objective to evaluate the clinical and imaging results of anterior decompression Zero-p interbody fusion cage in the treatment of cervical spondylosis. [methods] from January 2010 to January 2013, the data of patients with cervical spondylosis treated with anterior cervical discectomy and fusion (anterior cervical discectomy and fusion,ACDF) combined with Zero-p interbody fusion cage were analyzed retrospectively. The clinical function was evaluated by cervical dysfunction index (neck disability index,NDI) and pain visual analog score (visual analogue scale,VAS). The imaging evaluation was performed with anterior and lateral cervical X-ray films, and the angle of cervical vertebrae was measured by Cobb angle measurement. The Cobb angle of the upper and lower vertebrae and the thickness of the anterior cervical soft tissue of the C _ (3 鈮，

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