颈前路减压ROI-C融合固定术治疗脊髓型颈椎病

The Anterior Cervical Discectomy and ROI-C Fusion in the Treatment of Cervical Spondylotic Myelopathy

摘要:

摘要：[目的] 探究零切迹自稳型颈椎融合器（zero?notch self stabilizing?cervical?fusion?cage，ROI-C）在脊髓型颈椎病（cervical spondylotic myelopathy，CSM）患者颈前路减压融合术（anterior cervical discectomy and fusion，ACDF）中的治疗效果。[方法] 择取天津市人民医院2021年1月-2022年7月收治的CSM患者112例，抽签法随机将其分为ROI-C组56例与钛板组56例。对比两组围手术期、随访及影像学资料。[结果] ROI-C组手术时间、术中出血量、术后拔管时间及早期并发症发生率均显著少于钛板组（P＜0.05）。对比术前，两组术后3个月、末次随访颈部疼痛视觉模拟评分（VAS）、日本骨科协会评分（JOA）、颈椎功能障碍指数（NDI）评分均显著改善（P＜0.05），ROI-C组术后3个月VAS与NDI评分均显著低于钛板组（P＜0.05），两组末次随访时各项评分对比均无统计学差异（P＞0.05）。对比术前，两组术后3个月、末次随访颈椎前凸角（CL）、颈椎整体曲度、活动度（ROM）均显著提高（P＜0.05），C2-7终板后角距离（SVA）均显著减小（P＜0.05），两组术后3个月、末次随访时各影像学指标及骨性融合率对比均无统计学差异（P＞0.05）。[结论] ROI-C行ACDF治疗CSM可取得与钛板类似的效果，ROI-C在减少手术创伤、降低早期并发症发生率、改善短期疼痛、颈椎功能障碍上有优势。

Abstract:

Abstract: Objective To explore the efficacy of zero notch self-stabilizing cervical fusion cage (ROI-C) in anterior cervical discectomy and fusion (ACDF) in patients with cervical spondylotic myelopathy (CSM). Methods A total of 112 CSM patients admitted to Tianjin People's Hospital from January 2021 to July 2022 were randomly divided into ROI-C group (56 cases) and titanium plate group (56 cases) by drawing lots. The perioperative period, follow-up and imaging data of the two groups were compared. Results The operative time, intraoperative blood loss, postoperative extubation time and early complication rate in ROI-C group were significantly lower than those in titanium plate group (P < 0.05). Compared with those before surgery, the visual analogue score (VAS), Japanese Orthopaedic Association score (JOA) and neck disability index (NDI) scores of the two groups were significantly improved at 3 months after surgery and at the last follow-up (P < 0.05), and the VAS and NDI scores in the ROI-C group were significantly lower than those in the titanium plate group at 3 months after surgery (P < 0.05). There were no statistically significant differences in scores between the two groups at the last follow-up (P > 0.05). Compared with those before surgery, cervical lordosis angle (CL), cervical curvature and range of motion (ROM) significantly increased at 3 months after surgery and at the last follow-up (P < 0.05), while sagittal vertical axis (SVA) of C2-7 endplate significantly decreased in both groups (P < 0.05). There were no statistically significant differences in imaging indexes and bone fusion rate between the two groups at 3 months after the surgery and the last follow-up (P > 0.05). Conclusions ROI-C in the treatment of CSM with ACDF can achieve similar results as titanium plate, and ROI-C has advantages in reducing surgical trauma, reducing the incidence of early complications, improving short-term pain and cervical spine dysfunction. Key words: Cervical spondylotic myelopathy; Anterior cervical discectomy and fusion; Zero notch self-stabilizing cervical fusion cage