Department of Orthopaedics, The Second Hospital, Shanxi Medical University, Taiyuan, China.
Orthop Surg. 2020 Feb;12(1):248-253. doi: 10.1111/os.12621.
To observe and evaluate the clinical curative effect of a new type of open-powered cervical spine system developed for anterior cervical surgery.
A retrospective analysis was performed in our hospital in 2015-2017 of 329 orthopaedic patients treated with cervical anterior decompression, cage or titanium mesh graft fusion, new open-powered nail plate or traditional cervical anterior screw plate. A total of 154 (control group) and 175 (observation group) cases were fixed with conventional cervical- and new open-powered nail plates, respectively. Postoperative follow-up was performed. Cervical stability, internal fixation position, and bone graft fusion were evaluated by imaging. Operative time, intraoperative blood loss, cervical Cobb angle, pain visual analogue scale (VAS) score, and Japanese orthopaedic association (JOA) score were compared between the groups. JOA scoring (spinal cord function) and neurological function improvement rate (IR) were used to assess clinical efficacy.
The patients were followed up for 8-36 months with an average of 19.48 months. There was no significant difference in the operation time and intraoperative blood loss between the two groups (P > 0.05). In the control group, the Cobb angles of the cervical spine were 5.13° ± 1.28°, 10.46° ± 1.07°, and 9.72° ± 1.43° before and after the operation. The observation group was followed by the Cobb angle of the cervical spine before and after the operation. They were 4.96° ± 1.39°, 11.67° ± 0.93°, and 11.13° ± 1.19°, respectively; the JOA scores before the operation, 1 week after the operation, and at the last follow-up were (8.07 ± 1.13) points and (13.57 ± 0.82) points, and (14.19 ± 0.96) points, respectively; the IR was 86.52% ± 9.33%. The preoperative, postoperative 1 week, and last follow-up JOA scores in the observation group were (8.37 ± 1.29) points, (14.11 ± 0.93) points, and (14.95 ± 0.78) points respectively. The IR was 88.74% ± 8.16% in the scores; the VAS scores were (5.54 ± 0.89) points, (1.73 ± 0.71) points, and (1.48 ± 0.52) points in the preoperative, postoperative 1 week, and last follow-up in the control group. The VAS scores were (5.81 ± 0.94) points, (1.82 ± 0.61) points, and (1.16 ± 0.49) points before, 1 week, and after the final follow-up. The JOA score and IR, VAS score and preoperative comparison between the two groups were statistically significant (P < 0.05), but there was no statistically significant difference between the two groups (P > 0.05).
The new open-powered nail anterior cervical plate system can achieve the same clinical effect as the traditional anterior cervical plate fixation in anterior cervical surgery, but it can simplify the operation process, effectively make up for the shortcomings of the traditional anterior cervical plate operation, and obtain satisfactory clinical application effect, which is worthy of clinical promotion.
观察并评估新型开口动力型颈椎前路系统在颈椎前路手术中的临床疗效。
回顾性分析我院 2015-2017 年采用颈椎前路减压、融合器或钛网植骨融合、新型开口动力钉板或传统颈椎前路螺钉板固定的 329 例骨科患者。其中，154 例（对照组）和 175 例（观察组）分别采用常规颈椎钉板和新型开口动力钉板固定。术后随访，影像学评估颈椎稳定性、内固定位置、植骨融合情况。比较两组患者手术时间、术中出血量、颈椎 Cobb 角、疼痛视觉模拟评分（VAS）、日本骨科协会（JOA）评分。采用 JOA 评分（脊髓功能）和神经功能改善率（IR）评估临床疗效。
患者平均随访 8-36 个月，平均 19.48 个月。两组患者手术时间和术中出血量比较差异无统计学意义（P > 0.05）。对照组患者术后颈椎 Cobb 角分别为术前 5.13°±1.28°、术后 10.46°±1.07°、末次随访 9.72°±1.43°；观察组患者术后颈椎 Cobb 角分别为术前 4.96°±1.39°、术后 11.67°±0.93°、末次随访 11.13°±1.19°；两组患者术后 JOA 评分、术后 1 周、末次随访分别为术前 8.07±1.13 分、术后 13.57±0.82 分、末次随访 14.19±0.96 分；IR 为 86.52%±9.33%。观察组患者术后 1 周和末次随访 JOA 评分分别为（8.37±1.29）分、（14.11±0.93）分、（14.95±0.78）分；IR 为 88.74%±8.16%；VAS 评分分别为术前 5.54±0.89 分、术后 1 周 1.73±0.71 分、末次随访 1.48±0.52 分；对照组患者术后 1 周和末次随访 VAS 评分分别为术前 5.81±0.94 分、术后 1.82±0.61 分、末次随访 1.16±0.49 分。两组患者 JOA 评分和 IR、VAS 评分与术前比较，差异有统计学意义（P < 0.05）；两组间比较差异无统计学意义（P > 0.05）。
新型开口动力型颈椎前路钢板系统在颈椎前路手术中能达到与传统颈椎前路钢板固定相同的临床效果，但可简化手术操作过程，有效弥补传统颈椎前路手术的不足，获得满意的临床应用效果，值得临床推广。
