Lan Tao, Lin Jian-Ze, Hu Shi-Yu, Yang Xin-Jian, Chen Yang
J Back Musculoskelet Rehabil. 2018;31(2):299-304. doi: 10.3233/BMR-169708.
Retrospective study of 68 patients of symptomatic cervical spondylosis who were treated by anterior cervical discectomy and fusion (ACDF).
The purpose of this study was to compare the clinical and radiological outcomes of patients with single level cervical spondylosis using either zero-profile spacer (group A) or anterior cervical plate and cage (group B).
Clinical and radiological data of 68 patients undergoing ACDF from C3-C7 were collected retrospectively. There were 35 patients with a mean age of 54.05 years who received treatment by zero-profile implant. A total of 33 patients with a mean age of 52.09 years underwent fusion by traditional plate with cage. Group A and group B were followed up for an average of 23.68 months and 24.39 months, respectively. Age, blood loss, and operation time were assessed. The clinical outcomes were evaluated by JOA and VAS score before and after surgery. In addition, incidence of dysphagia was recorded. The Cobb angle (from C2 to C7) change was measured on the lateral cervical spine radiographs.
There was no significant difference in terms of operation time and blood loss between two groups. The postoperative JOA significantly increased and the VAS decreased correspondently in both groups. The postoperative Cobb angle increased and showed statistical difference compared with preoperative Cobb angle in both groups. There was no significant difference between group A and group B in achieving clinical symptoms and radiograph improvement according to postoperative JOA, VAS and Cobb angle comparison. The incidence of postoperative dysphagia was lower in the group A than group B.
Our study suggests that the application of zero-p spacer can achieve similar clinical and radiological improvement compared with traditional plate and cage. Meanwhile, zero-p is superior to plate and cage with a lower incidence of postoperative dysphagia.
对68例有症状的颈椎病患者行颈椎前路椎间盘切除融合术（ACDF）的回顾性研究。
本研究旨在比较单节段颈椎病患者使用零切迹椎间融合器（A组）或颈椎前路钢板及椎间融合器（B组）的临床和影像学结果。
回顾性收集68例行C3-C7节段ACDF患者的临床和影像学资料。35例平均年龄54.05岁的患者接受零切迹植入物治疗。33例平均年龄52.09岁的患者采用传统钢板联合椎间融合器进行融合。A组和B组分别平均随访23.68个月和24.39个月。评估年龄、失血量和手术时间。通过术前和术后的日本骨科协会（JOA）评分和视觉模拟评分法（VAS）评估临床结果。此外，记录吞咽困难的发生率。在颈椎侧位X线片上测量Cobb角（从C2至C7）的变化。
两组在手术时间和失血量方面无显著差异。两组术后JOA评分均显著提高，VAS评分相应降低。两组术后Cobb角均增大，与术前Cobb角相比有统计学差异。根据术后JOA、VAS和Cobb角比较，A组和B组在临床症状和影像学改善方面无显著差异。A组术后吞咽困难的发生率低于B组。
我们的研究表明，与传统钢板及椎间融合器相比，应用零切迹椎间融合器可获得相似的临床和影像学改善。同时，零切迹椎间融合器在术后吞咽困难发生率方面优于钢板及椎间融合器。
