Su Xin-Jin, Chen Xiu-Yuan, Dai Jia-Feng, Zhu Chao, Song Qing-Xin, Shen Hong-Xing
Department of Spine Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Spine Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Clin Neurol Neurosurg. 2023 Oct;233:107941. doi: 10.1016/j.clineuro.2023.107941. Epub 2023 Aug 9.
A retrospective study.
Conventional cage-plate construct (CCP) was widely used in anterior cervical discectomy and fusion (ACDF), but the rigid fixation limits the motion of fused segments. Self-locking stand-alone cage (SSC) was an alternative for ACDF procedures and showed several superiorities. However, the effect of hybrid fixation in 3-level ACDF remains unknown.
To assess the clinical and radiological outcomes of hybrid fixation with SSC and CCP against conventional CCP in 3-level ACDF.
A retrospective review of patients who underwent 3-level ACDF at Renji Hospital between January 2018 and December 2019 was performed. Eighty-three patients met the inclusion and exclusion criteria and were stratified into 2 groups based on the fixation methods. The clinical outcomes, functional outcomes, and radiological parameters were collected and analyzed.
No significant difference was observed between the two groups in the mean age, sex, body mass index, hospital stay, and duration of follow-up. The postoperative C2-7 Cobb angle in the CCP group was significantly greater than that in the hybrid group. The rate of cervical proximal junctional kyphosis (CPJK) in the hybrid group was significantly lower than that in the CCP group. The CCP group suffered significantly higher rates of adjacent segment degeneration (ASD) than the hybrid group at 2 years postoperatively. Moreover, the incidence of postoperative dysphagia was lower in the hybrid group. No significant differences were observed in JOA and NDI scores between the two groups.
The hybrid fixation achieved comparable clinical outcomes against CCP fixation, indicating that hybrid fixation is an alternative procedure in 3-level ACDF.
一项回顾性研究。
传统的椎间融合器-钢板结构（CCP）广泛应用于颈椎前路椎间盘切除融合术（ACDF），但其刚性固定限制了融合节段的活动。自锁独立椎间融合器（SSC）是ACDF手术的一种替代方案，并显示出一些优势。然而，三级ACDF中混合固定的效果仍不清楚。
评估三级ACDF中使用SSC和CCP进行混合固定与传统CCP固定的临床和影像学结果。
对2018年1月至2019年12月在仁济医院接受三级ACDF手术的患者进行回顾性研究。83例患者符合纳入和排除标准，并根据固定方法分为两组。收集并分析临床结果、功能结果和影像学参数。
两组在平均年龄、性别、体重指数、住院时间和随访时间方面无显著差异。CCP组术后C2-7 Cobb角显著大于混合组。混合组颈椎近端交界性后凸（CPJK）发生率显著低于CCP组。术后2年，CCP组相邻节段退变（ASD）发生率显著高于混合组。此外，混合组术后吞咽困难的发生率较低。两组间JOA和NDI评分无显著差异。
混合固定与CCP固定取得了相当的临床效果，表明混合固定是三级ACDF的一种替代手术方法。
