方法:回顾性研究。
目的:本研究的目的是比较颈椎前路椎间盘切除术和融合术(ACDF)与新型零轮廓可变角度(Zero-PVA)垫片和传统的聚醚醚酮(PEEK)笼和板系统在涉及神经根病/脊髓病的病例中的临床和放射学结果。有两种常规类型的ACDF程序旨在治疗症状性颈椎病。第一种是利用植骨/笼子的无仪器“独立”方法,而第二个结合了骨移植物/保持架以及位于椎体之前的前板。两种程序都有其固有的优点和缺点。Zero-PVA间隔物,然而,通过合并两种传统典型程序的优点,代表了一种独特的合成。值得注意的是,这种垫片可以潜在地规避与椎前软组织紊乱相关的问题,并减少吞咽困难的发生.
方法:使用我们的手术数据库,作者对2018年1月至2019年1月接受单水平ACDF的所有患者进行了回顾性分析,至少随访两年.患者接受了Zero-PVA植入物或PEEK笼以及电镀。记录了日本骨科协会(JOA)评分和手臂和颈部疼痛的视觉模拟评分(VAS)。使用进食评估工具-10(ETA-10)评估吞咽困难。其他参数,如子宫颈排列,评估融合率和术后并发症的发生率。
结果:根据统计分析的结果,在JOA和VAS指标中观察到的两个研究队列之间的进展没有显著差异.值得注意的是,然而,与笼型和平板组相比,Zero-PVA组的ETA-10评分显著降低(p<0.05).在最后的后续行动中,手术段的高度没有统计学上的显着差异,融合段的Cobb角,C2-C7Cobb角及融会率两组间比较(p>0.05)。然而,Zero-PVA组患者的术后并发症(7.69%)略低于cage和plating组(16.67%).
结论:发现用于单水平ACDF的Zero-PVA间隔区的临床结果令人满意。该装置在防止术后吞咽困难和减轻与使用板相关的潜在并发症方面的性能与传统的笼和平板方法相当或甚至优于传统的笼和平板方法。
METHODS: A retrospective
study.
OBJECTIVE: The aim of this
study was to compare clinical and radiological outcomes of the anterior cervical discectomy and fusion (ACDF) with a novel zero-profile variable-angle (Zero-P VA) spacer and a traditional poly-ether-ether-ketone (PEEK) cage and plate system in cases pertaining to cervical radiculopathy/myelopathy. There are two conventional types of ACDF procedures aimed at treating symptomatic cervical spondylosis. The first one involves an uninstrumented \"stand-alone\" approach utilizing bone graft/cage, while the second incorporates bone graft/cage in conjunction with a front plate positioned before the vertebral bodies. Both procedures have their own inherent advantages and disadvantages. The Zero-P VA spacer, however, represents a unique synthesis by amalgamating the advantages of both traditionally typical procedures. Notably, this spacer can potentially circumvent the issue related to prevertebral soft-tissue disturbance and reduce the occurrence of dysphagia.
METHODS: Using our surgical database, the authors systematically conducted a retrospective analysis encompassing all patients who underwent single-level ACDF between January 2018 and January 2019, with a minimum two-year follow-up. Patients either received a Zero-P VA implant or PEEK cage coupled with plating. The Japanese Orthopedic Association (JOA) score and Visual Analogue Scale (VAS) for arm and neck pain were documented. Dysphagia was evaluated using the Eating Assessment Tool-10 (ETA-10). Additional parameters such as cervical alignment, fusion rate and the incidence of postoperative complications were assessed.
RESULTS: According to the outcomes of the statistical analysis, there was no substantial disparity that emerged in the advancements observed in the JOA and VAS metrics between the two
study cohorts. Noteworthy, however, the ETA-10 scores were statistically significantly reduced in the Zero-P VA group compared to the cage and plating group (p < 0.05). At the final follow-up, there were no statistically significant differences in the height of the operated segment, Cobb angle of the fused segment, C2-C7 Cobb angle and fusion rate between the two groups (p > 0.05). However, postoperative complications were slightly lower in patients with the Zero-P VA group (7.69%) as compared to the cage and plating group (16.67%).
CONCLUSIONS: The clinical outcomes observed with the Zero-P VA spacer used for single-level ACDF were found to be satisfactory. The performance of this device is comparable or even superior to the traditional cage and plating method in preventing postoperative dysphagia and mitigating potential complications associated with the use of a plate.