CAJ | 학술논문

目的：探讨零切迹颈椎前路椎间融合固定系统（简称 Zero-P 系统）治疗颈椎病及无骨折脱位颈脊髓损伤患者的临床疗效。方法对行颈椎前路手术的14例颈椎病患者（16节段）和5例无骨折脱位颈脊髓损伤患者（5节段）采用 Zero-P 系统进行减压固定。观察手术时间、术中出血量、术后早期并发症；颈椎病患者采用 JOA 评分评价疗效。结果手术时间为55～120（75±16）min；术中出血量为50～450（150±85）ml。术后11例出现吞咽困难，2～5 d 基本恢复，未出现其他早期并发症。患者均获随访，时间3个月～3年6个月，末次随访时14例颈椎病患者 JOA 评分改善率为72．7％，其中优9例，良3例，中2例；5例颈脊髓损伤患者Frankel 分级均为 E 级。影像学资料提示术后椎间融合良好，未出现临近节段椎间盘退变。结论仅需处理椎间盘的颈椎前路手术采用 Zero-P 系统进行减压固定，可以取得早期良好的临床疗效，但应注意患者的选择。
목적：탐토령절적경추전로추간융합고정계통（간칭 Zero-P 계통）치료경추병급무골절탈위경척수손상환자적림상료효。방법대행경추전로수술적14례경추병환자（16절단）화5례무골절탈위경척수손상환자（5절단）채용 Zero-P 계통진행감압고정。관찰수술시간、술중출혈량、술후조기병발증；경추병환자채용 JOA 평분평개료효。결과수술시간위55～120（75±16）min；술중출혈량위50～450（150±85）ml。술후11례출현탄인곤난，2～5 d 기본회복，미출현기타조기병발증。환자균획수방，시간3개월～3년6개월，말차수방시14례경추병환자 JOA 평분개선솔위72．7％，기중우9례，량3례，중2례；5례경척수손상환자Frankel 분급균위 E 급。영상학자료제시술후추간융합량호，미출현림근절단추간반퇴변。결론부수처리추간반적경추전로수술채용 Zero-P 계통진행감압고정，가이취득조기량호적림상료효，단응주의환자적선택。
Objective To evaluate the clinical effect of Zero-P anterior cervical intervertebral fusion system(Zero-P ACIF)for cervical spondylotic myelopathy and spinal cord injury without fracture dislocation.Methods 14 cases of cervical spondylosis (16 section)and 5 cases of cervical spinal cord injury without fracture and dislocation (5 sec-tion)were treated with Zero-P ACIF by decompression and fixation;The results were evaluated by observing the oper-ative time,bleeding volume,postoperative complications and JOA score(cervical spondylosis patient).Results Operative time was 55 ~120(75 ±16)min,bleeding volume was 50 ~450(150 ±85)ml;11 cases got postoperative dysphagia,and recovered after 2 ~5 days,without other complications.All the patients had been followed up for 3 ~42 months;at last follow-up,JOA score of cervical spondylosis(14 cases)improvement rate were 72.7%.JOA score improvement rate analysis showed excellent in 9 cases,good in 3,fair in 2;5 cases of cervical spinal cord injury were Frankel E when they were followed up.Through observation the imaging data,postoperative intervertebral fusion were well,no adjacent segment disc degeneration was found.Conclusions Zero-P ACIF fixation system is effective in decompression and fixation of intervertebral disc anterior cervical operation.The indications should be controlled well.