桥型零切迹锚定式椎间间隔物（ROI-C）融合 Cage 系统与颈椎前路减压融合术（ACDF）加钢板 Cage 系统治疗脊髓型颈椎病的比较。
Comparing the Bridge-Type Zero-Profile Anchored Spacer (ROI-C) Interbody Fusion Cage System and Anterior Cervical Discectomy and Fusion (ACDF) with Plating and Cage System in Cervical Spondylotic Myelopathy.
机构信息
Department of Orthopedic Surgery, The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Danyang, China.
Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
Orthop Surg. 2022 Jun;14(6):1100-1108. doi: 10.1111/os.13268. Epub 2022 Apr 27.
OBJECTIVE
To compare the clinical efficacy and radioactivity of the bridge-type zero-profile anchored spacer (ROI-C) interbody fusion cage and anterior cervical discectomy and fusion with plating and cage system (ACDF) for cervical spondylotic myelopathy (CSM).
METHODS
This is a retrospective contrastive study. We recruited 35 patients who received ROI-C (ROI-C group) and 34 patients who received ACDF (ACDF group), between January 2014 to January 2019, at our treatment center. The ROI-C group comprised of 11 males and 24 females with a mean age of 61.59 ± 8.21 years (range, 51-71 years). The ACDF group comprised of 12 males and 22 females with a mean age of 60.15 ± 7.52 years (range, 52-74 years). Neck Disability Index (NDI), Japanese Orthopaedic Association score (JOA), Odom's score, cervical Cobb angle, fusion rate, adjoining ossification, and dysphagia.
RESULTS
A total of 69 patients met the inclusion criteria, and these patients received more than two years of follow-up. There were significant differences in surgical duration (101 ± 22 min vs. 118 ± 29 min) and blood loss (102 ± 46 ml vs. 145 ± 58 ml) between two groups (P < 0.05). The JOA and NDI of these two groups of patients significantly improved, when compared with those before the operation (P < 0.05). Twenty-nine of 35 patients in the ROI-C group and 27 of 34 patients in ACDF group achieved good or excellent outcomes according to Odom's criteria. The cervical lordosis of both two groups significantly increased, when compared with those before the operation (P < 0.05). In the ROI-C group, the postoperative fusion rate was 85.7% at the 3-month follow-up and 100% at the final follow-up. In the ACDF group, the postoperative fusion rate was 82.4% at the 3-month follow-up and 100% at the final follow-up. The dysphagia incidence of the ACDF group was higher than that of the ROI-C group postoperatively and at the one month after surgery (P < 0.05), but no significant difference was found in the incidence of dysphagia at final follow-up (P > 0.05).
CONCLUSION
Both ROI-C and ACDF achieved good therapeutic effects. However, ROI-C can reduce the operation time and postoperative complications.
目的
比较桥型零切迹锚定式椎间融合器（ROI-C）与前路颈椎间盘切除融合加钢板和 cage 系统（ACDF）治疗脊髓型颈椎病（CSM）的临床疗效和放射性。
方法
这是一项回顾性对比研究。我们招募了 2014 年 1 月至 2019 年 1 月在我们治疗中心接受 ROI-C（ROI-C 组）和 ACDF（ACDF 组）治疗的 35 例患者。ROI-C 组 11 例为男性，24 例为女性，平均年龄 61.59±8.21 岁（51-71 岁）。ACDF 组 12 例为男性，22 例为女性，平均年龄 60.15±7.52 岁（52-74 岁）。采用颈残障指数（NDI）、日本矫形协会评分（JOA）、Odom 评分、颈椎 Cobb 角、融合率、相邻骨化和吞咽困难。
结果
共有 69 例患者符合纳入标准，且这些患者均接受了 2 年以上的随访。两组手术时间（101±22min 比 118±29min）和出血量（102±46ml 比 145±58ml）差异有统计学意义（P<0.05）。两组患者的 JOA 和 NDI 均较术前明显改善（P<0.05）。ROI-C 组 35 例患者中 29 例和 ACDF 组 34 例患者中 27 例根据 Odom 标准达到良好或优效。两组术后颈椎前凸均较术前明显增加（P<0.05）。ROI-C 组术后 3 个月融合率为 85.7%，末次随访时为 100%。ACDF 组术后 3 个月融合率为 82.4%，末次随访时为 100%。ACDF 组术后吞咽困难发生率高于 ROI-C 组术后及术后 1 个月（P<0.05），但末次随访时吞咽困难发生率无差异（P>0.05）。
结论
ROI-C 和 ACDF 均取得了良好的治疗效果。然而，ROI-C 可以减少手术时间和术后并发症。
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