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与前路颈椎间盘切除融合术后使用钢板固定的椎间融合器相比,零轮廓锚定椎间融合器可降低术后吞咽困难的风险。

Zero-profile anchored cage reduces risk of postoperative dysphagia compared with cage with plate fixation after anterior cervical discectomy and fusion.

作者信息

Xiao ShanWen, Liang ZhuDe, Wei Wu, Ning JinPei

机构信息

Department of Spine and Orthopaedic Surgery, Red Cross Hospital of Guangxi Wuzhou, Xin Xing Road 1. #3-1, Wuzhou, 543000, China.

出版信息

Eur Spine J. 2017 Apr;26(4):975-984. doi: 10.1007/s00586-016-4914-5. Epub 2016 Dec 21.

Abstract

PURPOSE

To compare the rate of postoperative dysphagia between zero-profile anchored cage fixation (ZPC group) and cage with plate fixation (CP group) after anterior cervical discectomy and fusion (ACDF).

METHODS

A meta-analysis of cohort studies between zero-profile anchored cage and conventional cage with plate fixation after ACDF for the treatment of cervical diseases from 2008 to May 2016. An extensive search of studies was performed in PubMed, Medline, Embase, Cochrane library and Google Scholar. Dysphagia rate was extracted. Data analysis was conducted with RevMan 5.2.

RESULTS

Sixteen trials involving 1066 patients were included in this meta-analysis. The results suggested that the ZPC group were associated with lower incidences of dysphagia than the CP group at postoperative immediately, 2 weeks, 2, 3, 6 and 12 months. In subgroup analysis, although significant differences were only found in the mild dysphagia at 3 and 6 months postoperatively and in the moderate dysphagia at 2 weeks after surgery; the ZPC group had a lower rate of postoperative dysphagia than the CCP group in short, medium and long term follow-up periods.

CONCLUSIONS

Zero-profile anchored cage had a lower risk of postoperative dysphagia than cage with plate.

摘要

目的

比较颈椎前路椎间盘切除融合术(ACDF)后零切迹锚定椎间融合器固定组(ZPC组)与椎间融合器联合钢板固定组(CP组)术后吞咽困难的发生率。

方法

对2008年至2016年5月期间应用零切迹锚定椎间融合器和传统椎间融合器联合钢板固定治疗颈椎病的队列研究进行荟萃分析。通过在PubMed、Medline、Embase、Cochrane图书馆和谷歌学术上广泛检索研究。提取吞咽困难发生率。使用RevMan 5.2进行数据分析。

结果

本荟萃分析纳入了16项试验,共1066例患者。结果表明,ZPC组在术后即刻、2周、2、3、6和12个月时吞咽困难的发生率低于CP组。在亚组分析中,虽然仅在术后3个月和6个月的轻度吞咽困难以及术后2周的中度吞咽困难中发现显著差异;但在短期、中期和长期随访期内,ZPC组术后吞咽困难的发生率低于CP组。

结论

零切迹锚定椎间融合器术后吞咽困难的风险低于椎间融合器联合钢板。

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