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在颈椎前路椎体次全切除融合术治疗双节段脊髓型颈椎病中,使用可吸收螺钉与钢板固定的界面固定效果比较。

Interface Fixation Using Absorbable Screws versus Plate Fixation in Anterior Cervical Corpectomy and Fusion for Two-Level Cervical Spondylotic Myelopathy.

机构信息

Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland).

Department of Orthopedics, Xi'an International Rehabilitation Medical Center, Xi'an, Shaanxi, China (mainland).

出版信息

Med Sci Monit. 2020 Mar 20;26:e921507. doi: 10.12659/MSM.921507.

Abstract

BACKGROUND We compared the clinical and radiographic outcomes between interface fixation using absorbable screws and plate fixation in anterior cervical corpectomy and fusion (ACCF) to evaluate the effectiveness of these 2 fixation methods for the treatment of 2-level cervical spondylotic myelopathy (CSM). MATERIAL AND METHODS From January 2014 to December 2016, a total of 220 patients who received 2-level ACCF were retrospectively collected. Among them, 108 patients were treated with interface fixation using absorbable screws (Group A) and 112 patients underwent plate fixation (Group B). Japanese Orthopedic Association (JOA) score and Neck Disability Index (NDI) score were employed to compare the clinical improvement. Operative time, blood loss, surgical cost, cervical lordosis, complications, and fusion rate were also evaluated. RESULTS The average follow-up time were 35.2±4.5 months in Group A and 35.9±3.9 months in Group B. There was no difference in operative time and blood loss for both groups. The JOA scores and NDI scores were similar in each follow-up (p>0.05 in all). Group A cost an average of 30% less than Group B for the operation. Both groups achieved 100% in the fusion rate with the same conditions in cervical lordosis. Group A (5/108) had a significantly lower complication rate than Group B (17/112) (p<0.05). CONCLUSIONS ACCF with interface fixation using absorbable screws achieved similar clinical outcomes compared to ACCF with plate fixation for 2-level CSM. Moreover, the interface fixation using absorbable screws presented far fewer complications and cost less for the operation.

摘要

背景

我们比较了在前路颈椎椎体次全切除融合术(ACCF)中使用可吸收螺钉和钢板固定界面的临床和影像学结果,以评估这两种固定方法治疗 2 级脊髓型颈椎病(CSM)的效果。

材料和方法

回顾性收集了 2014 年 1 月至 2016 年 12 月接受 2 级 ACCF 的 220 例患者。其中 108 例采用可吸收螺钉界面固定(A 组),112 例采用钢板固定(B 组)。采用日本矫形协会(JOA)评分和颈部残疾指数(NDI)评分比较临床疗效。评估手术时间、出血量、手术费用、颈椎前凸、并发症和融合率。

结果

A 组平均随访时间为 35.2±4.5 个月,B 组为 35.9±3.9 个月。两组手术时间和出血量无差异。每组在每次随访时的 JOA 评分和 NDI 评分均相似(p>0.05)。A 组的手术费用平均比 B 组低 30%。两组在颈椎前凸方面均达到 100%的融合率,且条件相同。A 组(5/108)的并发症发生率明显低于 B 组(17/112)(p<0.05)。

结论

在治疗 2 级 CSM 方面,使用可吸收螺钉的界面固定与使用钢板的 ACCF 具有相似的临床效果。此外,使用可吸收螺钉的界面固定术并发症更少,手术费用更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7673/7106970/5de651921996/medscimonit-26-e921507-g001.jpg

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