Sun Zhicheng, Liu Zheng, Hu Wenkai, Yang Yan, Xiao Xiao, Wang Xiyang
Department of Spine Surgery, Xiangya Hospital, Central South University, Hunan, People's Republic of China; Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, Xiangya Hospital, Central South University, Hunan, People's Republic of China.
Department of Spine Surgery, Xiangya Hospital, Central South University, Hunan, People's Republic of China; Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, Xiangya Hospital, Central South University, Hunan, People's Republic of China.
World Neurosurg. 2018 Dec;120:e551-e561. doi: 10.1016/j.wneu.2018.08.128. Epub 2018 Aug 29.
In recent years, increasing numbers of cervical disease cases have been treated with zero-profile devices in anterior cervical discectomy and fusion (ACDF). Its short-term efficacy has been widely recognized; however, the evidence for long-term efficacy remains insufficient. The present study assessed the mid-term and long-term efficacy of zero-profile compared with cage and plate structures in ACDF by analyzing the clinical and radiological outcomes after treatment of cervical diseases with a minimum 2 years of follow-up.
We conducted a comprehensive database or platform search in PubMed, ISI Web of Science, Embase, and Cochrane Central Register of Controlled Trials using the PRISMA guidelines and identified 10 reports, with 772 patients (375 in the zero-profile group and 397 in the cage and plate group) that met our inclusion criteria. All patients had been followed up for ≥2 years. Two of us used a standardized data collection form to extract relevant data and check its accuracy independently.
The zero-profile group had statistically significant (P < 0.05) less intraoperative blood loss, improved postoperative C2-C7 Cobb angle, and decreased incidence of postoperative dysphagia and adjacent segment degeneration compared with the cage and plate group. The operative time, postoperative Japanese Orthopaedic Association score, Neck Disability Index score, and bone fusion rate showed no statistically significant differences between the 2 groups.
The zero-profile and cage and plate structures achieved comparable mid-term and long-term clinical and radiological outcomes in ACDF. In addition, the zero-profile group showed reduced intraoperative blood loss, improved postoperative C2-C7 Cobb angle, and decreased incidence of dysphagia and adjacent segment degeneration complications.
近年来，越来越多的颈椎病病例在前路颈椎间盘切除融合术（ACDF）中采用零切迹装置进行治疗。其短期疗效已得到广泛认可；然而，长期疗效的证据仍然不足。本研究通过分析至少随访2年的颈椎病治疗后的临床和影像学结果，评估了ACDF中零切迹装置与椎间融合器及钢板结构相比的中期和长期疗效。
我们按照PRISMA指南在PubMed、ISI科学网、Embase和Cochrane对照试验中心注册库中进行了全面的数据库或平台检索，共识别出10篇报告，其中772例患者（零切迹组375例，椎间融合器及钢板组397例）符合我们的纳入标准。所有患者均随访≥2年。我们两人使用标准化数据收集表独立提取相关数据并检查其准确性。
与椎间融合器及钢板组相比，零切迹组术中出血量显著减少（P < 0.05），术后C2-C7 Cobb角改善，术后吞咽困难和相邻节段退变的发生率降低。两组的手术时间、术后日本矫形外科学会评分、颈部功能障碍指数评分和骨融合率无统计学显著差异。
在ACDF中，零切迹装置与椎间融合器及钢板结构在中期和长期的临床及影像学结果相当。此外，零切迹组术中出血量减少，术后C2-C7 Cobb角改善，吞咽困难和相邻节段退变并发症的发生率降低。
