CAJ | 학술논문

背景：颈前路椎间盘切除减压植骨融合使用颈前路钢板可能引起治疗后吞咽困难等并发症。 　　目的：观察采用颈椎前路一体化Zero-p椎间融合器置入治疗颈椎病的临床疗效以及减少治疗后并发症的优势。 　　方法：采用颈椎前路一体化Zero-p椎间融合器行颈前路椎间盘切除减压植骨融合治疗颈椎病患者51例。在治疗前、治疗后第3天，治疗后3，6个月，治疗后1年及2年等时间节点采用颈部及上肢疼痛目测类比评分、颈椎功能障碍指数、日本矫形外科学会评分法对患者的神经功能情况进行评估；采用吞咽困难评分法对患者术后吞咽困难相关并发症的发生情况进行评估；拍摄颈椎正侧位及动力位X射线片评价术后植骨融合程度及内固定相关并发症情况。 　　结果与结论：患者随访时间为6-30个月，平均15.4个月。治疗后切口均Ⅰ期愈合，所有患者治疗后获得疼痛缓解，肌力恢复；目测类比评分及颈椎功能障碍指数评分均较术前有显著改善；脊髓型颈椎病患者日本矫形外科学会评分平均改善率为85.7%。治疗后第2天有7例患者出现轻、中度的吞咽困难。随访期间未发现内置物沉降，也未发生螺钉松动、断裂或内固定器移位等并发症。表明颈前路椎间盘切除减压植骨融合式中采用颈椎前路一体化Zero-p椎间融合器置入治疗颈椎病的近期临床效果良好，其设计同时具备了颈椎间融合器以及颈椎前路固定钢板的优点，内固定相关并发症少。
배경：경전로추간반절제감압식골융합사용경전로강판가능인기치료후탄인곤난등병발증。 　　목적：관찰채용경추전로일체화Zero-p추간융합기치입치료경추병적림상료효이급감소치료후병발증적우세。 　　방법：채용경추전로일체화Zero-p추간융합기행경전로추간반절제감압식골융합치료경추병환자51례。재치료전、치료후제3천，치료후3，6개월，치료후1년급2년등시간절점채용경부급상지동통목측류비평분、경추공능장애지수、일본교형외과학회평분법대환자적신경공능정황진행평고；채용탄인곤난평분법대환자술후탄인곤난상관병발증적발생정황진행평고；박섭경추정측위급동력위X사선편평개술후식골융합정도급내고정상관병발증정황。 　　결과여결론：환자수방시간위6-30개월，평균15.4개월。치료후절구균Ⅰ기유합，소유환자치료후획득동통완해，기력회복；목측류비평분급경추공능장애지수평분균교술전유현저개선；척수형경추병환자일본교형외과학회평분평균개선솔위85.7%。치료후제2천유7례환자출현경、중도적탄인곤난。수방기간미발현내치물침강，야미발생라정송동、단렬혹내고정기이위등병발증。표명경전로추간반절제감압식골융합식중채용경추전로일체화Zero-p추간융합기치입치료경추병적근기림상효과량호，기설계동시구비료경추간융합기이급경추전로고정강판적우점，내고정상관병발증소。
BACKGROUND:The application of anterior cervical plate for anterior cervical discectomy and fusion wil induce some complications such as dysphagia after treatment. OBJECTIVE:To observe the clinical efficacy of the new implant Zero-P system for cervical spondylosis patients and its effect on reducing complications after treatment. METHODS:A total of 51 cervical spondylosis cases underwent anterior cervical discectomy and fusion using Zero-P system. Neurological function was evaluated by neck/arm visual analogue scale, neck disability index and Japanese Orthopaedic Association scores pretreatment, at 3 days, 3, 6 months, 1, 2 years post-treatment. The incidence of postoperative dysphagia was evaluated using dysphagia score. Anteroposterior&lateral and dynamics X-ray films were used to evaluate the efficacy of graft fusion and internal fixation-related complications. RESULTS AND CONCLUSION:The patients were fol owed up for 6-30 months, averagely 15.4 months. After treatment, their incision achieved stage I healing. Pain was relieved and muscle force was restored in al patients after treatment. Visual analogue scale and neck disability index scores were apparently improved. Improvement rate of Japanese Orthopaedic Association score was 85.7%. At 2 days after treatment, seven patients experienced mild and moderate dysphagia. During fol ow up, implant subsidence was not observed. No complications, such as screw loose, breakage or fixator displacement, were found. Results suggested that the new cervical stand-alone anterior fusion device in anterior cervical discectomy and fusion procedure for the treatment of cervical spondylosis has offered an excellent clinical outcome. Its design has the advantages of cervical interbody fusion and anterior cervical plate. There were less relevant complications.