Yang Lili, Gu Yifei, Liang Lei, Gao Rui, Shi Sheng, Shi Jueqian, Yuan Wen
Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Orthopedics. 2012 Oct;35(10):e1503-10. doi: 10.3928/01477447-20120919-20.
The purpose of this study was to compare the clinical outcomes and radiological changes of 3- and 4-level anterior cervical diskectomy and fusion with stand-alone anchored spacers and with traditional anterior plates. A total of 51 consecutive patients with cervical spondylotic myelopathy who underwent 3- or 4-level anterior cervical diskectomy and fusion were divided into 2 groups: group A (n=23) received anchored spacers and group B (n=28) received an anterior plate. Mean follow-up was 14.6 months. Solid fusion was achieved in all patients at final follow-up. No significant difference existed between multilevel anterior cervical diskectomy and fusion with stand-alone anchored implants and with an anterior cervical plate in achieving clinical symptomatic improvement, fusion rate, and lordotic curvature improvement. The dysphagia rate of group A at 2-month follow-up was significantly lower than that of group B. No statistically significant difference existed between the 2 groups at the other time points. Swallowing Quality of Life of group A at 48 hours and 2 months postoperatively were significantly higher than those of group B. The thickness of the prevetebral soft tissue at 48 hours and 2 months postoperatively were significantly lower in group A than in group B. Compared with using an anterior plate, anterior cervical diskectomy and fusion with a stand-alone anchored spacer achieved a similar clinical outcome with less irritation to the prevertebral soft tissue and a lower dysphagia rate in the first 2 months.
本研究的目的是比较3节段和4节段颈椎前路椎间盘切除融合术使用单独锚定椎间融合器与传统前路钢板的临床疗效和影像学变化。共有51例连续接受3节段或4节段颈椎前路椎间盘切除融合术的脊髓型颈椎病患者被分为2组：A组（n=23）接受锚定椎间融合器，B组（n=28）接受前路钢板。平均随访时间为14.6个月。所有患者在末次随访时均实现了坚固融合。在实现临床症状改善、融合率和颈椎前凸改善方面，多节段颈椎前路椎间盘切除融合术使用单独锚定植入物与使用颈椎前路钢板之间无显著差异。A组在2个月随访时的吞咽困难发生率显著低于B组。在其他时间点，两组之间无统计学显著差异。A组术后48小时和2个月时的吞咽生活质量显著高于B组。A组术后48小时和2个月时的椎体前软组织厚度显著低于B组。与使用前路钢板相比，颈椎前路椎间盘切除融合术使用单独锚定椎间融合器可获得相似的临床疗效，对椎体前软组织的刺激更小，且在最初2个月内吞咽困难发生率更低。
