Orthopedics Department, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, China.
Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China.
Injury. 2019 Apr;50(4):908-912. doi: 10.1016/j.injury.2019.03.029. Epub 2019 Mar 18.
Postoperative dysphagia is one major concern in the treatment for patients with cervical spine spondylosis by using anterior cervical discectomy and fusion (ACDF) with plating and cage system.
To evaluate the influence of two types of surgery for multilevel cervical spondylotic myelopathy (CSM) on postoperative dysphagia, namely ACDF with cage alone (ACDF-CA) using Fidji cervical cages and ACDF with cage and plate fixation (ACDF-CP).
A retrospective study was performed in 62 consecutive patients with multilevel CSM, including 32 underwent ACDF-CA (group A) and 30 underwent ACDF-CP (group B). All enrolled patients were followed up at 48 h, 2 months and 6 months postoperatively, when the dysphagia rate, Swallowing-Quality of Life (SWAL-QOL) score and the thickness of prevertebral soft tissue were recorded.
At 48 h and 2 months, the dysphagia rate and thickness of prevertebral soft tissue were both significantly lower in group A than in group B, while the SWAL-QOL score of group A was significantly higher than that of group B. No significant difference was observed at 6 months.
Fidji cervical cages could relieve postoperative dysphagia in the treatment of multilevel CSM with ACDF, especially at the first several months postoperatively.
颈椎前路椎间盘切除融合术（ACDF）联合钢板和 cage 系统治疗颈椎病患者术后吞咽困难是一个主要关注点。
评估两种手术方式治疗多节段脊髓型颈椎病（CSM）对术后吞咽困难的影响，即使用 Fidji 颈椎 cage 进行单纯 ACDF（ACDF-CA）和使用 cage 联合钢板固定的 ACDF（ACDF-CP）。
对 62 例多节段 CSM 患者进行回顾性研究，其中 32 例行 ACDF-CA（A 组），30 例行 ACDF-CP（B 组）。所有入组患者均在术后 48 小时、2 个月和 6 个月进行随访，记录吞咽困难发生率、吞咽生活质量问卷（SWAL-QOL）评分和椎体前软组织厚度。
在术后 48 小时和 2 个月时，A 组的吞咽困难发生率和椎体前软组织厚度均显著低于 B 组，而 A 组的 SWAL-QOL 评分显著高于 B 组。在术后 6 个月时，两组间无显著差异。
在治疗多节段 CSM 的 ACDF 中，Fidji 颈椎 cage 可缓解术后吞咽困难，尤其是在术后的前几个月。
