PDF(Pubmed)
Abstract：
BACKGROUND: In recent years, the zero-profile implant (Zero-p) has emerged as a promising internal fixation technique. Although studies have indicated its potential superiority over conventional cage-plate implant (Cage-plate) in the treatment of degenerative cervical spondylosis, there remains a lack of definitive comparative reports regarding its indications, safety, and efficacy.
METHODS: A computerized search was conducted on English and Chinese databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, Wanfang and VIP. Additionally, a manual search was meticulously carried out on Chinese medical journals, spanning from the inception of the respective databases until August 2023. The meta-analysis utilized a case-control study approach and was executed through the utilization of RevMan 5.3 software. Stringent quality evaluation and data extraction procedures were implemented to guarantee the reliability and validity of the findings.
RESULTS: Nine high-quality studies with 808 patients were included. Meta-analysis showed that the operation time (MD = - 13.28; 95% CI (- 17.53, - 9.04), P < 0.00001), intraoperative blood loss (MD = - 6.61; 95% CI (- 10.47, - 2.75), P = 0.0008), incidence of postoperative dysphagia at various time points: within the first month after surgery (OR = 0.36; 95% CI (0.22, 0.58), P < 0.0001), 1-3 months after surgery (OR = 0.20; 95% CI (0.08, 0.49), P = 0.0004), the final follow-up (OR = 0.21; 95% CI (0.05, 0.83), P = 0.003) and the rate of postoperative adjacent disc degeneration (OR = 0.46; 95% CI (0.25, 0.84), P = 0.01) were significantly lower in the Zero-p group than in the Cage-plate group. Additionally, was also significantly lower in the Zero-p group. However, there were no significant differences in the JOA score, the final follow-up NDI score, surgical segmental fusion rate, postoperative height of adjacent vertebrae, or postoperative subsidence rate between the two groups.
CONCLUSIONS: In summary, when treating single-segment degenerative cervical spondylosis, both internal fixation techniques are reliable and effective. However, Zero-P implant offer several advantages over cage-plate implant, including shorter operation duration, less intraoperative blood loss, reduced postoperative dysphagia, and slower adjacent disc degeneration. Additionally, Zero-P implant has a broader application space, making them a preferred choice in certain cases.
METHODS: A computerized search was conducted on English and Chinese databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, Wanfang and VIP. Additionally, a manual search was meticulously carried out on Chinese medical journals, spanning from the inception of the respective databases until August 2023. The meta-analysis utilized a case-control study approach and was executed through the utilization of RevMan 5.3 software. Stringent quality evaluation and data extraction procedures were implemented to guarantee the reliability and validity of the findings.
RESULTS: Nine high-quality studies with 808 patients were included. Meta-analysis showed that the operation time (MD = - 13.28; 95% CI (- 17.53, - 9.04), P < 0.00001), intraoperative blood loss (MD = - 6.61; 95% CI (- 10.47, - 2.75), P = 0.0008), incidence of postoperative dysphagia at various time points: within the first month after surgery (OR = 0.36; 95% CI (0.22, 0.58), P < 0.0001), 1-3 months after surgery (OR = 0.20; 95% CI (0.08, 0.49), P = 0.0004), the final follow-up (OR = 0.21; 95% CI (0.05, 0.83), P = 0.003) and the rate of postoperative adjacent disc degeneration (OR = 0.46; 95% CI (0.25, 0.84), P = 0.01) were significantly lower in the Zero-p group than in the Cage-plate group. Additionally, was also significantly lower in the Zero-p group. However, there were no significant differences in the JOA score, the final follow-up NDI score, surgical segmental fusion rate, postoperative height of adjacent vertebrae, or postoperative subsidence rate between the two groups.
CONCLUSIONS: In summary, when treating single-segment degenerative cervical spondylosis, both internal fixation techniques are reliable and effective. However, Zero-P implant offer several advantages over cage-plate implant, including shorter operation duration, less intraoperative blood loss, reduced postoperative dysphagia, and slower adjacent disc degeneration. Additionally, Zero-P implant has a broader application space, making them a preferred choice in certain cases.
摘要：
背景：近年来，零轮廓植入物（Zero-p）已成为一种有前途的内固定技术。尽管研究表明其在治疗退行性颈椎病方面优于传统的笼型钢板植入物（Cage-plate），关于其适应症仍然缺乏明确的比较报告，安全,和功效。
方法:对中英文数据库进行了计算机检索,包括PubMed,WebofScience,科克伦图书馆,EMBASE,CNKI,万方和VIP。此外,在中国医学期刊上精心进行了人工搜索，从各自的数据库开始到2023年8月。荟萃分析采用病例对照研究方法，并通过使用RevMan5.3软件进行。实施了严格的质量评估和数据提取程序，以确保研究结果的可靠性和有效性。
结果：纳入了9项高质量研究，共808例患者。Meta分析显示手术时间(MD=-13.28;95%CI(-17.53,-9.04),P<0.00001),术中失血（MD=-6.61；95%CI（-10.47，-2.75），P=0.0008),术后吞咽困难在不同时间点的发生率：在手术后的第一个月内（OR=0.36;95％CI（0.22，0.58），P<0.0001),术后1-3个月（OR=0.20；95%CI（0.08，0.49），P=0.0004),最终随访（OR=0.21；95%CI（0.05，0.83），P=0.003)和术后邻近椎间盘退变率(OR=0.46;95%CI(0.25,0.84),P=0.01）在Zero-p组明显低于Cage-plate组。此外,在Zero-p组中也显著较低。然而,JOA评分没有显著差异，最终的后续NDI得分，手术节段融合率，术后相邻椎骨高度，或术后沉降率比较两组。
结论：总之，治疗单节段退行性颈椎病时，两种内固定技术都是可靠和有效的。然而,零P植入物比笼形钢板植入物有几个优点，包括较短的操作持续时间，术中失血少,减少术后吞咽困难，相邻椎间盘退变较慢。此外,零P植入物具有更广阔的应用空间,在某些情况下，使它们成为首选。
方法:对中英文数据库进行了计算机检索,包括PubMed,WebofScience,科克伦图书馆,EMBASE,CNKI,万方和VIP。此外,在中国医学期刊上精心进行了人工搜索，从各自的数据库开始到2023年8月。荟萃分析采用病例对照研究方法，并通过使用RevMan5.3软件进行。实施了严格的质量评估和数据提取程序，以确保研究结果的可靠性和有效性。
结果：纳入了9项高质量研究，共808例患者。Meta分析显示手术时间(MD=-13.28;95%CI(-17.53,-9.04),P<0.00001),术中失血（MD=-6.61；95%CI（-10.47，-2.75），P=0.0008),术后吞咽困难在不同时间点的发生率：在手术后的第一个月内（OR=0.36;95％CI（0.22，0.58），P<0.0001),术后1-3个月（OR=0.20；95%CI（0.08，0.49），P=0.0004),最终随访（OR=0.21；95%CI（0.05，0.83），P=0.003)和术后邻近椎间盘退变率(OR=0.46;95%CI(0.25,0.84),P=0.01）在Zero-p组明显低于Cage-plate组。此外,在Zero-p组中也显著较低。然而,JOA评分没有显著差异，最终的后续NDI得分，手术节段融合率，术后相邻椎骨高度，或术后沉降率比较两组。
结论：总之，治疗单节段退行性颈椎病时，两种内固定技术都是可靠和有效的。然而,零P植入物比笼形钢板植入物有几个优点，包括较短的操作持续时间，术中失血少,减少术后吞咽困难，相邻椎间盘退变较慢。此外,零P植入物具有更广阔的应用空间,在某些情况下，使它们成为首选。
