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Received:March 11, 2024 Published Online:February 20, 2025
Received:March 11, 2024 Published Online:February 20, 2025
中文摘要: 目的 比较前入路颈椎减压融合术（ACDF）应用零切迹自稳型颈椎融合器（ROI-C）与钛板联合融合器固定治疗颈椎病的临床疗效。方法 回顾性分析2019年12月至2022年10月在南京医科大学第四附属医院行ACDF治疗的退行性颈椎病患者112例。其中63例采用ROI-C系统固定（ROI-C组），49例采用钛板融合器固定（钛板组）。收集两组患者术前和术后第3天、1个月和12个月时的颈椎功能障碍指数（NDI），日本骨科协会（JOA）评分，标准吞咽功能评价量表（SSA）评分，颈椎C2～C7曲度，手术节段椎体高度，融合器下沉情况及其他术后并发症发生情况。结果 所有患者手术顺利完成，术中无严重并发症，随访12～20（14.39±1.81）个月。两组术前JOA、NDI和SSA评分、颈椎曲度和手术节段椎间隙高度比较差异无统计学意义（P＞0.05）。术后各时间点两组患者颈椎曲度、椎间隙高度、NDI及JOA评分较术前均显著改善（P＜0.05），术后第3天及1个月随访时，ROI-C组SSA评分低于钛板组（P＜0.05）。末次随访时，ROI-C组融合器下沉发生率高于钛板组（23.8% vs 8.2%， χ2=4.790， P＜0.05）。结论 ACDF中使用两种不同融合器结构均能够颈椎功能及生活质量均有所改善，ROI-C融合器可降低吞咽功能障碍的发生率，但融合器下沉率有所上升。
Abstract:Objective To compare the clinical efficacy of zero notch self stabilizing cervical fusion cage (ROI-C) versus titanium plate-based fusion devices in anterior cervical discectomy and fusion (ACDF) for the treatment of cervical spondylosis. Methods A total of 112 patients with degenerative cervical spondylosis who underwent ACDF from December 2019 to October 2022 at the Fourth Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Among them, 63 cases were fixed with the ROI-C system (ROI-C group), 49 cases were fixed with titanium plate fusion devices (titanium plate group). The cervical dysfunction index (NDI), Japanese Orthopedic Association (JOA) score, Standardized Swallowing Assessment Scale (SSA) score, cervical spine curvature from C2 to C7 vertebral height of the operated segments, fusion device subsidence, and the incidence of other postoperative complications were collected from the patients in both groups at the preoperative and postoperative days 3, 1 month, and 12 months. Results All patients underwent surgery successfully without any serious complications, and were followed up for 12-20 months, with an average of (14.39±1.81) months. There was no statistically significant difference in preoperative JOA, NDI and SSA scores, cervical curvature and height of intervertebral space at the operated segment between the two groups (P＞0.05). Cervical curvature, intervertebral space height, NDI and JOA scores were significantly improved in both groups at all postoperative time points compared with the preoperative period (P＜0.05), and SSA scores in the ROI-C group were significantly lower than those in the titanium plate group at the 3-day and 1-month postoperative follow-ups (P＜0.05). At the last follow-up, the incidence of fusion device subsidence was higher in the ROI-C group than that in the titanium plate group (23.8% vs 8.2%， χ2=4.790， P＜0.05). Conclusion The use of two different fusion cage structures in ACDF can improve cervical function and quality of life. The ROI-C cervical cage can reduce the incidence of swallowing dysfunction, but the rate of fusion subsidence is increased.
keywords: Cervical degenerative disease Anterior cervical decompression and fusion surgery ROI-C fusion Titanium plate fusion Fusion subsidence Swallowing dysfunction
文章编号： 中图分类号：R681.5 文献标志码：A
基金项目:南京市中医药青年人才培养计划（ZYQ20075）
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