Lu Yingjie, Bao Weiguo, Wang Zongyi, Zhou Feng, Zou Jun, Jiang Weimin, Yang Huilin, Zhang Zhiming, Zhu Xuesong
Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou Department of Orthopaedics, Shanghai Bone Tumor Institute, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Medicine (Baltimore). 2018 Feb;97(5):e9808. doi: 10.1097/MD.0000000000009808.
Comparing the clinical and radiographic outcomes in anterior cervical discectomy and fusion (ACDF) using a zero-profile anchored spacer (ROI-C) or a conventional cage-plate construct (CPC) for treating noncontiguous bilevel of cervical degenerative disc disease (CDDD).Overall, 46 patients with 2 noncontiguous segments of CDDD, treated with ACDF from January 2011 to October 2015, were included in this study. ROI-C was used in 22 patients (group A) and CPC in 24 patients (group B). The clinical and radiographic outcomes and complications were compared pre- and postoperatively. All patients were followed up for at least 24 months after surgery.No significant difference was found in fusion rate, cervical curvature, height of fused segment (FSDH), intraoperative blood loss, and Japanese Orthopaedic Association (JOA), and Neck Disability Index (NDI) scores between the 2 groups. Group A had a shorter operation time and significantly lower incidence of dysphagia (3 and 24 months postoperatively) than group B (P < .001 and P < .05, respectively). Moreover, group A had a higher loss of FSDH than group B, but with no difference between the 2 groups (P > .05). Two cages developed subsidence in group A (4.5%) and 2 adjacent levels developed degeneration in group B (2,8%).ACDF with ROI-C device was superior to CPC for noncontiguous bilevel of CDDD because it avoided postoperative dysphagia and required a shorter operation time. Moreover, the clinical outcomes were comparable. Prospective trials with larger samples and longer follow-up are required to confirm the results.
比较使用零轮廓锚定椎间融合器（ROI-C）或传统椎间融合器-钢板结构（CPC）进行颈椎前路椎间盘切除融合术（ACDF）治疗非连续性双节段颈椎退行性椎间盘疾病（CDDD）的临床和影像学结果。总体而言，本研究纳入了2011年1月至2015年10月期间接受ACDF治疗的46例患有2个非连续性节段CDDD的患者。22例患者使用ROI-C（A组），24例患者使用CPC（B组）。比较两组术前和术后的临床和影像学结果及并发症。所有患者术后均随访至少24个月。两组在融合率、颈椎曲度、融合节段高度（FSDH）、术中失血量、日本骨科协会（JOA）评分和颈部功能障碍指数（NDI）评分方面均未发现显著差异。A组的手术时间较短，吞咽困难发生率（术后3个月和24个月）明显低于B组（分别为P<0.001和P<0.05）。此外，A组的FSDH丢失高于B组，但两组之间无差异（P>0.05）。A组有2个椎间融合器出现下沉（4.5%），B组有2个相邻节段出现退变（2.8%）。对于非连续性双节段CDDD，采用ROI-C装置的ACDF优于CPC，因为它避免了术后吞咽困难，且手术时间较短。此外，临床结果相当。需要进行更大样本量和更长随访时间的前瞻性试验来证实这些结果。
