首页|应用自锁式零切迹椎间融合器治疗老年人长节段颈椎病的疗效分析

应用自锁式零切迹椎间融合器治疗老年人长节段颈椎病的疗效分析

Efficacy of a self-locking zero-notch interbody fusion device for treating long-segment cervical spondylosis in elderly patients

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目的 应用自锁式零切迹椎间融合器治疗老年人群长节段颈椎病,与传统钛板联合椎间融合器手术结果进行对比,评估零切迹椎间融合器的治疗效果.方法 2019年1月至2021年1月,回顾性收集3~4节段(C3~C7)神经根型颈椎病、脊髓型颈椎病、混合型颈椎病的老年患者(>60岁)病例,采用零切迹椎间融合器(A组,24例)或传统钛板联合椎间融合器(B组,18 例)行颈椎前路椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF).记录手术时间、出血量、切口长度、住院时间.测量术前、术后颈椎各方向椎间隙高度、功能段高度和颈椎前凸角.观察两组治疗效果,记录术后相关并发症.结果 两组患者性别、年龄、日本骨科协会(Japanese Orthopaedic Association,JOA)评分、上肢疼痛评分(visual analogue scale,VAS)、颈椎功能障碍指数(neck disability index,NDI)、术前颈椎间隙高度、功能段高度及颈椎前凸角差异均无统计学意义.两组患者手术时间、手术出血量、住院天数差异均无统计学意义,A组患者切口短于B组(P<0.01).两组患者术后JOA评分、上肢VAS、术后NDI差异均无统计学意义.两组患者术后椎间隙高度、功能段高度、颈椎前凸角的恢复差异均无统计学意义.结论 零切迹椎间融合器是治疗长节段颈椎病的有效方法,与传统钛板联合椎间融合器相比,可避免术后吞咽困难,切口更小,手术时间更短,更适用于老年患者.
Objective To compare the therapeutic efficacy of a self-locking zero-notch interbody fusion device for long-segment cervical spondylosis in elderly patients with traditional titanium plate combined with interbody fusion device.Methods From Jan 2019 to Jan 2021,elderly patients(>60 years)with 3-4 segments(C3-C7)radiculopathy,myelopathy,or mixed-type cervical spondylosis underwent anterior cervical discectomy and fusion(ACDF)using a zero-notch interbody fusion device(Group A,n=24)and ACDF using a titanium plate combined with an interbody fusion device(Group B,n=18).We recorded the surgery duration,blood loss,incision length and hospital stay,measure preoperative and postoperative intervertebral height,functional segment height and cervical lordosis,and also observe treatment outcomes and postoperative complications between the two groups.Results There were no statistically significant differences between the two groups in terms of gender,age,Japanese Orthopaedic Association(JOA)score,visual analogue scale(VAS)of upper limb,Neck Disability Index(NDI),preoperative intervertebral height,functional segment height and cervical lordosis.Blood loss,surgery time and hospital stay were similar in both groups,but Group A had shorter incision length(P<0.01)compared with Group B.There were no significant differences between the two groups in JOA scores,upper limb VAS and postoperative NDI,and even in postoperative intervertebral height,functional segment height and cervical lordosis recovery.Conclusion The zero-notch interbody fusion device is effective for treating long-segment cervical spondylosis.Compared with the traditional titanium plate combined with an interbody fusion device,it can avoid postoperative dysphagia with smaller incision and shorter surgery time,which makes it more suitable for elderly patients.

long-segment cervical spondylosiszero-notch interbody fusion deviceanterior cervical surgerydysphagiathe elderly

张瑛凯、夏阔、王厚磊、王京、周嘉琦、赵明东

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复旦大学附属金山医院骨科 上海 201508

复旦大学附属中山医院骨科 上海 200032

长节段颈椎病 零切迹椎间融合器 颈椎前路手术 吞咽困难 老年人

2025

复旦学报(医学版)
复旦大学

复旦学报(医学版)

北大核心
影响因子:1.206
ISSN:1672-8467
年,卷(期):2025.52(1)