| 零切迹自稳性颈椎融合器治疗颈椎病合并骨质疏松 |
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投稿时间：2020-08-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 赵继福 |
ZHAO Ji-fu |
东莞市第八人民医院骨外科, 广东 东莞 523325 |
Department of Orthopaedics, the 8th People's Hospital of Dongguan, Dongguan 523325, Guangdong, China |
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| 万乾 |
WAN Qian |
东莞市第八人民医院骨外科, 广东 东莞 523325 |
Department of Orthopaedics, the 8th People's Hospital of Dongguan, Dongguan 523325, Guangdong, China |
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| 崔文波 |
and CUI Wen-bo |
东莞市第八人民医院骨外科, 广东 东莞 523325 |
Department of Orthopaedics, the 8th People's Hospital of Dongguan, Dongguan 523325, Guangdong, China |
cuiwenbo635790@qq.Com |
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| 期刊信息：《中国骨伤》2021年，第34卷，第1期，第68-72页 |
| DOI：10.12200/j.issn.1003-0034.2021.01.013 |
| 基金项目: |
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中文摘要:目的：探讨零切迹自稳性颈椎融合器（ROI-C）治疗老年颈椎病合并骨质疏松患者的临床疗效。
方法：2013年5月至2018年5月经颈椎前路行ROI-C治疗颈椎病患者145例，其中年龄≥ 60岁且经骨密度测定存在骨质疏松症患者31例，对其进行回顾性分析。31例患者中男9例，女22例，年龄60~84（69.12±7.65）岁；单节段23例，双节段6例，3节段2例，共置入ROI-C融合器41枚。记录患者手术时间、术中出血量，分别采用日本骨科协会（Japanese Orthopaedic Association，JOA）评分和视觉模拟评分法（visual analogue scale，VAS）评价手术前后的神经功能及颈部疼痛情况，并通过影像学资料观察手术前后的颈椎生理曲度（以Cobb角表示）、手术节段椎间隙高度及椎间融合情况。
结果：31例患者术后均获得随访，时间12~24（15.6±4.4）个月。手术时间75~113（101.33±10.25） min，术中出血量14~51（33.18±16.56） ml；其中23例单节段患者手术时间75~98（85.47±8.70） min，术中出血量14~30（21.18±6.56） ml。31例患者JOA评分术前为9.66±2.12，末次随访时提高至14.36±1.24（P<0.05）；VAS评分术前为4.21±0.83，末次随访时下降至1.12±0.57（P<0.05）；颈椎Cobb角术前为（13.14±4.54）°，末次随访时改善至（22.31±5.42）°（P<0.05）；手术椎间隙高度由术前的（3.28±0.73） mm恢复至末次随访的（4.87±0.45） mm （P<0.05）。所有患者末次随访时手术节段已融合，未发现融合器失效情况。末次随访时无吞咽苦难、声音嘶哑等并发症。
结论：经颈椎前路应用ROI-C治疗老年颈椎病合并骨质疏松患者疗效可靠，手术时间短，术中出血少，并可有效恢复颈椎生理曲度及椎间隙高度，且术后并发症少，融合成功率高。 |
| 【关键词】颈椎病 骨质疏松 脊柱融合术 |
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| Zero-profile anchored spacer(ROI-C) for the treatment of cervical spondylosis with osteoporosis |
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ABSTRACT Objective: To investigate the clinical efficacy of zero-profile anchored spacer (ROI-C) in treating cervical spondylosis with osteoporosis.
Methods: From May 2013 to May 2018,a total of 145 patients with cervical spondylosis were treated by ROI-C through anterior cervical spine approach. Among them,31 patients were aged ≥ 60 years and had osteoporosis by bone density measurement,and they were retrospectively analyzed. Including 9 males and 22 females,aged 60-84 years old with an average of (69.12±7.65) years. There were 23 cases of single-segment fusion,6 cases of two-stage fusion,and 2 cases of three-stage fusion;and 41 devices of ROI-C fusion was placed in the patients. Operation time and intraoperative blood loss were recorded;Japanese Orthopaedic Association (JOA) scores and visual analogue scale(VAS) were respectively used to evaluate the neurological function and neck pain before and after operation. The cervical curvature (expressed as Cobb angle),the height of the intervertebral space at the surgical segment,and the intervertebral fusion were observed at postoperative and follow-up periods were observed by image data.
Results: All patients were followed up for 12-24(15.6±4.4) months after operation. The operation time were from 75 to 113(101.33±10.25) min and intraoperative blood loss were from 14 to 51(33.18 ±16.56) ml. Among these 23 patients with fusion of single segment,the operation time were 75 to 98(85.47±8.70) min and intraoperative blood loss were 14 to 30(21.18±6.56) ml. JOA scores of all included patients were increased from 9.66±2.12 preoperatively to 14.36±1.24 at the final follow-up(P<0.05);VAS scores were decreased form 4.21±0.83 preoperatively to 1.12±0.57 at the final follow-up(P<0.05);Cobb angles of the cervical spine were improved from (13.14±4.54)° preoperatively to (22.31±5.42)° at the final follow-up(P<0.05);the heights of the intervertebral space were changed from (3.28±0.73) mm preoperatively to (4.87±0.45) mm at the final follow-up(P<0.05). All the fusions of the surgical segments were satisfactory at the inal follow-up and no failure of the fusion device was found. At the final follow-up,no complications such as difficulty swallowing and hoarseness,etc. were reported.
Conclusion: Anterior cervical approach with ROI-C for the treatment of elderly patients with cervical spondylosis and osteoporosis had reliable clinical effect,short operation time,less intraoperative blood loss,and can effectively restore cervical curvature and intervertebral space height,and has advantages of fewer complications and higher successful rate of fusion. |
| KEY WORDS Cervical spondylosis Osteoporosis Spinal fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 赵继福,万乾,崔文波.零切迹自稳性颈椎融合器治疗颈椎病合并骨质疏松[J].中国骨伤,2021,34(1):68~72 |
| 英文格式: | ZHAO Ji-fu,WAN Qian,and CUI Wen-bo.Zero-profile anchored spacer(ROI-C) for the treatment of cervical spondylosis with osteoporosis[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(1):68~72 |
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