零切迹颈前路椎间融合固定系统治疗颈椎病的早期疗效分析_《中国修复重建外科杂志》

作者：

方明 , 陆建猛 , 韦勇力 , 俞武良 , 王兴武 , 欧阳甲

宁波大学医学院附属医院脊柱外科（浙江宁波，315020）;

关键词：

颈椎病零切迹颈前路椎间融合固定系统颈前路融合术

DOI：

10.7507/1002-1892.20130264

视频：

导出 下载 收藏 扫码 引用

摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的评价应用零切迹颈前路椎间融合固定系统（Zero-profile implant system，Zero-P）行颈前路融合术的早期疗效。方法2010年3月－2011月6月收治颈椎病患者25例，男13例，女12例；年龄26～67岁，平均44.2岁。病程3～120个月，中位病程25个月。其中神经根型颈椎病14例，脊髓型6例，混合型5例。单节段20例，双节段4例，三节段1例。初次行颈椎手术者23例，颈椎术后再手术2例。均行经前路椎间盘切除减压、Zero-P固定术；共植入Zero-P 31枚，其中C3、4 3枚、C4、5 8枚、C5、6 12枚、C6、7 8枚；手术前后定期摄X线片，测量椎间隙高度、颈椎Cobb角，采用疼痛视觉模拟评分（VAS）记录颈痛与上肢痛、日本骨科协会（JOA）评分评价脊髓功能；并观察植骨融合及吞咽不适相关并发症的发生情况。结果术后切口均Ⅰ期愈合。25例均获随访，随访时间12～16个月，平均13.9个月。31个椎间隙均获骨性融合，融合时间2.7～6.0个月，平均3.8个月。3例患者术后出现吞咽不适，其中2例表现为吞咽痛，术后1周内症状消失；1例诉咽部异物感，症状持续至术后3个月消失。随访期间未见内固定物松动、沉降、断裂等情况。术前及术后1周、12个月患者椎间隙高度分别为（4.5 ± 0.5）、（6.0 ± 0.7）、（5.7 ± 0.6）mm，颈椎Cobb角分别为（11.9 ± 6.1）、（21.2 ± 4.1）、（20.2 ± 3.7）°，术后两时间点均较术前显著改善（P lt; 0.05），术后两时间点间比较差异无统计学意义（P gt; 0.05）。术前及术后3、12个月患者VAS评分分别为（7.1 ± 0.8）、（1.9 ± 0.8）、（1.0 ± 0.5）分，JOA评分分别为（9.6 ± 1.3）、（13.5 ± 1.0）、（14.9 ± 1.0）分，术后两时间点均较术前显著改善（P lt; 0.05），术后两时间点间比较差异也有统计学意义（P lt; 0.05）。结论Zero-P治疗颈椎病手术效果好，融合率高，术后吞咽不适相关并发症发生率低，可重建并维持颈椎高度和曲度，早期疗效满意。

引用本文： 方明,陆建猛,韦勇力,俞武良,王兴武,欧阳甲. 零切迹颈前路椎间融合固定系统治疗颈椎病的早期疗效分析. 中国修复重建外科杂志, 2013, 27(10): 1206-1209. doi: 10.7507/1002-1892.20130264 复制

1.	Vaccaro AR, Cearrino JA, Venger BH, et al. Use of a bioabsorbable anterior cervical plate in the treatment of cervical degenerative and traumatic disc disruption. J Neurosurg, 2002, 97(4): 473-480.
2.	Korinth MC. Treatment of cervical degenerative disc disease: current status and trends. Zentralbl Neurochir, 2008, 69(3): 113-124.
3.	Matz PG, Ryken TC, Groff MW, et al. Techniques for anterior cervica decompression for radiculopathy. J Neurosurg Spine, 2009, 11(2): 183-197.
4.	Fujibayashi S, Neo M, Nakamura T. Stand-alone interbody cage versus anterior cervical plate for treatment of cervical disc hernation: sequential changes in cage subsidence. J Clin Neurosci, 2008, 15(9): 1017-1022.
5.	Moon HJ, Kim JH, Kim JH, et al. The effects of anterior cervical discectomy and fusion with stand-alone cages at two contiguous levels on cervical alignment and outcomes. Acta Neurochir, 2011, 153(3): 559-565.
6.	Anderson DG, Albert TJ. Bone grafting, implants, and plating options for anterior cervical fusions. Orthop Clin North Am, 2002, 33(2): 317-328.
7.	Böhler J, Gaudernak T. Anterior plate stabilization for fracturedislocations of the lower cervical spine. J Trauma, 1980, 20(3): 203-205.
8.	Scholz M, Schnake KL, Pingel A, et al. A new zero-profile implant for stand-alone anterior cervical interbody fusion. Clin Orthop Relat Res, 2011, 469(3): 666-673.
9.	Yang JY, Song HS, Lee M, et al. Adjacent level ossification deveIopment after anterior cervical fusion without plate fixation. Spine (Phila Pa 1976), 2009, 34(1): 30-33.
10.	Hwang SH, Kayanja M, Milks RA, et al. Biomechanical comparison of adjacent segmental motion after ventral cervical fixaton with varying angles of lordosis. Spine (Phila Pa 1976), 2007, 7(2): 216-221.
11.	Faldini C, Pagkrati S, Leonetti D, et al. Sagittal segmental alignment as predictor of adjacent-level degeneration after a cloward procedure. Clin Orthop Relat Res, 2011, 469(3): 674-681.
12.	Tortolani PJ, Cunningham BW, Vigna F, et al. A comparison of retraction pressure during anterior cervical plate surgery and cervical disc replacement: a cadaveric study. J Spinal Disord Tech, 2006, 19(5): 312-317.
13.	Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976), 2002, 27(22): 2453-2458.
14.	Lee MJ, Bazaz R, Furey CG, et al. Influence of anterior cervical plate design on dysphagia: a 2-year prospective longitudinal follow-up study. J Spinal Disord Tech, 2005, 18(5): 406-409.
15.	Kasimatis GB, Panagiotopoulos E, Gliatis J, et al. Complications of anterior surgery in cervical spine trauma: an overview. Clin Neurol Neurosurg, 2009, 111(1): 18-27.
16.	Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976), 2002, 27(22): 2453-2458.
17.	Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976), 2007, 32(21): 2310-2317.
18.	Riley LH 3rd, Skolasky RL, Albert TJ, et al. Dysphagia after anterior cervical decompression and fusion: prevalence and risk factors from a longitudinal cohort study. Spine (Phila Pa 1976), 2005, 30(22): 2564-2569.
19.	Yue WM, Brodner W, Highland TR. Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study. Eur Spine J, 2005, 14(7): 677-682.

1. Vaccaro AR, Cearrino JA, Venger BH, et al. Use of a bioabsorbable anterior cervical plate in the treatment of cervical degenerative and traumatic disc disruption. J Neurosurg, 2002, 97(4): 473-480.
2. Korinth MC. Treatment of cervical degenerative disc disease: current status and trends. Zentralbl Neurochir, 2008, 69(3): 113-124.
3. Matz PG, Ryken TC, Groff MW, et al. Techniques for anterior cervica decompression for radiculopathy. J Neurosurg Spine, 2009, 11(2): 183-197.
4. Fujibayashi S, Neo M, Nakamura T. Stand-alone interbody cage versus anterior cervical plate for treatment of cervical disc hernation: sequential changes in cage subsidence. J Clin Neurosci, 2008, 15(9): 1017-1022.
5. Moon HJ, Kim JH, Kim JH, et al. The effects of anterior cervical discectomy and fusion with stand-alone cages at two contiguous levels on cervical alignment and outcomes. Acta Neurochir, 2011, 153(3): 559-565.
6. Anderson DG, Albert TJ. Bone grafting, implants, and plating options for anterior cervical fusions. Orthop Clin North Am, 2002, 33(2): 317-328.
7. Böhler J, Gaudernak T. Anterior plate stabilization for fracturedislocations of the lower cervical spine. J Trauma, 1980, 20(3): 203-205.
8. Scholz M, Schnake KL, Pingel A, et al. A new zero-profile implant for stand-alone anterior cervical interbody fusion. Clin Orthop Relat Res, 2011, 469(3): 666-673.
9. Yang JY, Song HS, Lee M, et al. Adjacent level ossification deveIopment after anterior cervical fusion without plate fixation. Spine (Phila Pa 1976), 2009, 34(1): 30-33.
10. Hwang SH, Kayanja M, Milks RA, et al. Biomechanical comparison of adjacent segmental motion after ventral cervical fixaton with varying angles of lordosis. Spine (Phila Pa 1976), 2007, 7(2): 216-221.
11. Faldini C, Pagkrati S, Leonetti D, et al. Sagittal segmental alignment as predictor of adjacent-level degeneration after a cloward procedure. Clin Orthop Relat Res, 2011, 469(3): 674-681.
12. Tortolani PJ, Cunningham BW, Vigna F, et al. A comparison of retraction pressure during anterior cervical plate surgery and cervical disc replacement: a cadaveric study. J Spinal Disord Tech, 2006, 19(5): 312-317.
13. Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976), 2002, 27(22): 2453-2458.
14. Lee MJ, Bazaz R, Furey CG, et al. Influence of anterior cervical plate design on dysphagia: a 2-year prospective longitudinal follow-up study. J Spinal Disord Tech, 2005, 18(5): 406-409.
15. Kasimatis GB, Panagiotopoulos E, Gliatis J, et al. Complications of anterior surgery in cervical spine trauma: an overview. Clin Neurol Neurosurg, 2009, 111(1): 18-27.
16. Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine (Phila Pa 1976), 2002, 27(22): 2453-2458.
17. Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976), 2007, 32(21): 2310-2317.
18. Riley LH 3rd, Skolasky RL, Albert TJ, et al. Dysphagia after anterior cervical decompression and fusion: prevalence and risk factors from a longitudinal cohort study. Spine (Phila Pa 1976), 2005, 30(22): 2564-2569.
19. Yue WM, Brodner W, Highland TR. Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study. Eur Spine J, 2005, 14(7): 677-682.

《中国修复重建外科杂志》

零切迹颈前路椎间融合固定系统治疗颈椎病的早期疗效分析

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

《中国修复重建外科杂志》

零切迹颈前路椎间融合固定系统治疗颈椎病的早期疗效分析

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

摘要全文图表视频参考文献施引文献补充材料