CAJ | 학술논문

目的：探讨颈椎前路减压手术中采用Zero-P与颈椎钢板椎间融合器内固定系统治疗单节段颈椎椎间盘突出症的临床疗效。方法2010年1月～2013年1月，本院前路减压手术治疗单节段颈椎椎间盘突出症患者共71例， A组中36例采用Zero-P，B组中35例采用前路钢板。于术前、术后3 d、术后6个月及末次评估影像学检查、视觉模拟量表（visual analog scale， VAS）评分、日本骨科学会（Japanese Orthopaedic Association，JOA）评分及改良吞咽生活质量量表（swallowing-quality of life，SWAL-QOL）评分。结果 A组手术时间和出血量较B组明显减少（P＜0．05）。2组患者术后均获得满意的临床症状和神经功能改善，每组VAS评分、JOA评分均较术前均明显改善（ P＜0．05）。 A组和B组患者术后吞咽不适发生率分别为13．9％和34．3％，A组术后吞咽不适发生率和SWAL-QOL评分与B组存在显著差异（P＜0．05）。2组患者术后内固定相关并发症发生率在统计学上未见明显差异。结论 Zero-P在手术时间、出血量和术后吞咽不适相关并发症上较前路钢板存在明显优势。因此，单节段颈椎前路手术可以首先考虑采用Zero-P内固定系统。
목적：탐토경추전로감압수술중채용Zero-P여경추강판추간융합기내고정계통치료단절단경추추간반돌출증적림상료효。방법2010년1월～2013년1월，본원전로감압수술치료단절단경추추간반돌출증환자공71례， A조중36례채용Zero-P，B조중35례채용전로강판。우술전、술후3 d、술후6개월급말차평고영상학검사、시각모의량표（visual analog scale， VAS）평분、일본골과학회（Japanese Orthopaedic Association，JOA）평분급개량탄인생활질량량표（swallowing-quality of life，SWAL-QOL）평분。결과 A조수술시간화출혈량교B조명현감소（P＜0．05）。2조환자술후균획득만의적림상증상화신경공능개선，매조VAS평분、JOA평분균교술전균명현개선（ P＜0．05）。 A조화B조환자술후탄인불괄발생솔분별위13．9％화34．3％，A조술후탄인불괄발생솔화SWAL-QOL평분여B조존재현저차이（P＜0．05）。2조환자술후내고정상관병발증발생솔재통계학상미견명현차이。결론 Zero-P재수술시간、출혈량화술후탄인불괄상관병발증상교전로강판존재명현우세。인차，단절단경추전로수술가이수선고필채용Zero-P내고정계통。
Objective To compare the clinical efficacy between anterior cervical discectomy and fusion with Zero -profile implant and with titanium plate implant for patients with single-segment anterior cervical disc herniation .Methods From Jan-uary 2010 to January 2013, total 71 patients treated with the Zero-P fixation system or the anterior plate titanium implant for cervical disc herniation were reviewed for this study .Of 71 patients,there were 36 cases treated with a Zero-P fixation system in A group and the 35 cases with anterior plate implant in B group .The status of the above patients were evaluated preopera-tively, 3 d postoperatively and 6 months postoperatively with physical examination ,radiological examination ,the visual analog scale ( VAS) ,Japan Orthopaedic Association ( JOA) and swallowing-quality of life ( SWAL-QOL) were adopt for determining the status of patients.Results The operation time and blood loss in A group was less than B group (P<0.05).All the patients in 2 groups had a satisfied neurologic outcome improvement .The VAS score and JOA score in each group were signifi-cantly improved (P<0.05).The dysphagia incidence of A and B group was 13.9% and 34.3%, respectively.There were significant differences in terms of the postoperative dysphagia incidence and SWAL -QOL score between A and B group ( P<0.05).There was no statistically significant difference in the 2 groups in the fixed-related complication rate.Conclusion Zero-P implant has distinct advantages in operation times , blood loss and postoperative dysphagia compared with the anteriorplate implant.Therefore, Zero-P is first considered for anterior cervical fusion surgery of single -segment cervical discherniation.