CAJ | 학술논문

目的比较颈椎动态稳定器(DCI)植入术与颈前路椎间减压Cage植入融合术在治疗单节段脊髓型颈椎病的早期疗效.方法对2011年3月至2013年1月间行颈前路DCI植入术(DCI组)23例,与行颈前路椎间减压Cage植入融合术(ACDF组)47例患者进行随访,于术后6、12、18个月行日本矫形外科协会(JOA)评分,拍摄X线平片观察椎间隙高度及上下邻近节段活动度.结果两组术后各时间点JOA评分、椎间隙高度与术前比较差异均有统计学意义(P＜0.05),随访各时间点组间比较差异无统计学意义(P＞0.05),DCI组随访期末上下邻近节段活动度[(6.92±0.31)°、(6.75±0.42)°]与术前[(6.78±0.51)°、(6.63±0.48)°]比较差异无统计学意义(P＞0.05),ACDF组随访期末上下邻近节段活动度[(8.27±0.43)°、(8.21±0.62)°]均较术前[(6.81±0.53)°、(6.67±0.49)°]增加(P＜0.05).结论两组方法均能明显缓解患者症状,恢复并维持椎间高度,但PCI植入术能较好的维持相邻节段正常活动度,可能有助于防止邻近节段的退变.
목적 비교경추동태은정기(DCI)식입술여경전로추간감압Cage식입융합술재치료단절단척수형경추병적조기료효.방법 대2011년3월지2013년1월간행경전로DCI식입술(DCI조)23례,여행경전로추간감압Cage식입융합술(ACDF조)47례환자진행수방,우술후6、12、18개월행일본교형외과협회(JOA)평분,박섭X선평편관찰추간극고도급상하린근절단활동도.결과 량조술후각시간점JOA평분、추간극고도여술전비교차이균유통계학의의(P＜0.05),수방각시간점조간비교차이무통계학의의(P＞0.05),DCI조수방기말상하린근절단활동도[(6.92±0.31)°、(6.75±0.42)°]여술전[(6.78±0.51)°、(6.63±0.48)°]비교차이무통계학의의(P＞0.05),ACDF조수방기말상하린근절단활동도[(8.27±0.43)°、(8.21±0.62)°]균교술전[(6.81±0.53)°、(6.67±0.49)°]증가(P＜0.05).결론 량조방법균능명현완해환자증상,회복병유지추간고도,단PCI식입술능교호적유지상린절단정상활동도,가능유조우방지린근절단적퇴변.
Objective To compare post-operative short-term clinical outcomes between dynamic cervical implant (DCI) non-fusion group and anterior decompression fusion with cage (ACDF) group.Methods From March 2011 to January 2013,23 patients were subjected to DCI non-fusion and 47 to ACDF respectively.The clinical outcomes were evaluated by JOA scores and we had all treated patients reexamined lateral (full extention) views during follow-up at 6 months,12 months,18 months respectively aiming to observes (the height of the treated level and the segmental ROM of adjacent levels of treated level) for both groups.Results Both the two groups showed good clinical outcomes by JOA scaling,we found no statistical significance between them (P ＞ 0.05),There is also no statistical significance between them in recovering and keeping the height of the treated level.At final following-up the ROM of adjacent levels treated [(6.92 ± 0.31) °,(6.75 ± 0.42) °] with DC1 we found no statistical difference from that of pre-operative [(6.78 ± 0.51) °,(6.63 ± 0.48) °] (P ＞ 0.05),but the ACDF group,Post-operatively the ROM of adjacent levels treated [(6.92 ± 0.31) °,(6.75 ± 0.42) °] at final following-up compared with pre-operative [(6.81 ± 0.53) °,(6.67 ± 0.49) °] show a marked increase (P ＜ 0.05).Conclusion Both the two groups can effectively treat the cervical diseased and greatly recover the height of the treated level.But DCI non-fusion can prevent the compensatory hyper-motion at adjacent levels,as a result,it may greatly decrease the rate of developing degenerative lesions in the long run.