Wang Fang, Li Jie, Diao Pan, Li Feng-Tao, Wang Dong, Li Hao-Peng, He Xi-Jing
The Second Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi, China.
Zhongguo Gu Shang. 2021 Jan 25;34(1):33-9. doi: 10.12200/j.issn.1003-0034.2021.01.007.
To explore the short-term clinical efficacy of single-stage cervical spondylotic radiculopathy (CSR) between the minimally invasive Key-hole technique and anterior cervical Zero profile intervertebral fusion system (Zero-P).
A retrospective analysis was performed on 45 patients who underwent surgical treatment for CSR from January 2017 to January 2020, including 21 in Key hole group (12 males and 9 females), followed up for 10-22(13.2±2.3) months;24 cases in Zero-P group (14 males and 10 females), and the follow up period was 10 to 23(12.7±1.9) months. Perioperative conditions (incision length, intraoperative blood loss, operation time, length of hospital stay, and complications) were compared between two groups, and X-rays of cervical spine before and after surgery and at the final follow-up were taken to analyzed curvature of the cervical spine, visual analogue scale(VAS) of pain before and after surgery, Oswestry Disability Index(ODI) and Japanese Orthopaedic Association (JOA) score of cervical spine were recorded to evaluate clinical efficacy.
In Key-hole group and Zero-P group, the surgical incision length, intraoperative blood loss, operation time, final follow-up Cobb angle and immediate postoperative VAS score respectively were (1.2±0.2) cm, (5.3±0.3) cm;(35.3±9.7) ml, (120.2±13.5) ml;(56.4±11.3) min, (90.6±12.6) min;(3.2±3.9)°, (7.3±3.8)°;(2.8±1.2)points, (3.8±1.1) points;the Zero-P group was larger than the Key hole group, with statistical significance(<0.05) . There were no statistically significant difference in length of hospital stay, ODI and JOA scores between two groups (>0.05). After the follow-up, 1 case of neurostimulation symptoms in Key-hole group was relieved by conservative treatment, 2 cases improved after reoperation due to recurrence of cervical disc herniation;2 cases of neurostimulation symptoms in Zero-P group, 2 cases of throat discomfort, and 1 case dural tears were all relieved by conservative treatment.
The cervical spine Key-hole technology is similar to the anterior cervical Zero-P system in the treatment of CSR. The Key-hole technique has certain advantages in incision length, intraoperative blood loss, and operation time. It is a safe, effective and can be widely used cervical spine surgery method.
探讨单节段神经根型颈椎病(CSR)采用微创钥匙孔技术与颈椎前路零切迹椎间融合系统(Zero-P)治疗的短期临床疗效。
回顾性分析2017年1月至2020年1月接受手术治疗的45例CSR患者,其中钥匙孔组21例(男12例,女9例),随访10 - 22(13.2±2.3)个月;Zero-P组24例(男14例,女10例),随访10至23(12.7±1.9)个月。比较两组围手术期情况(切口长度、术中出血量、手术时间、住院时间及并发症),并拍摄手术前后及末次随访时的颈椎X线片分析颈椎曲度,记录手术前后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)及日本骨科学会(JOA)颈椎评分以评估临床疗效。
钥匙孔组与Zero-P组手术切口长度、术中出血量、手术时间、末次随访Cobb角及术后即刻VAS评分分别为(1.2±0.2)cm,(5.3±0.3)cm;(35.3±9.7)ml,(120.2±13.5)ml;(56.4±11.3)min,(90.6±12.6)min;(3.2±3.9)°,(7.3±3.8)°;(2.8±1.2)分,(3.8±1.1)分;Zero-P组均大于钥匙孔组,差异有统计学意义(<0.05)。两组住院时间、ODI及JOA评分比较差异无统计学意义(>0.05)。随访后,钥匙孔组1例神经刺激症状经保守治疗缓解,2例因颈椎间盘突出复发再次手术后好转;Zero-P组2例神经刺激症状、2例咽喉部不适及1例硬脊膜撕裂均经保守治疗缓解。
颈椎钥匙孔技术与颈椎前路Zero-P系统治疗CSR效果相似。钥匙孔技术在切口长度、术中出血量及手术时间方面具有一定优势。是一种安全、有效且可广泛应用的颈椎手术方法。