Abstract: 【Abstract】〓Objective〓To compare the difference of operation time, blood loss, incidence of dysphagia,.outcome and incidence of internal fixation failure between Zero-p anterior cervical intervertebral fusion system and locking plate combines with cage for cervical spondylosis. Methods Forty-nine patients with single-level cervical spondylosis admitted in our hospital from 2012 to 2014 were included in the study and a retrospective clinical data were analyzed. Of 49 cases, 23 were treated by using Zero-p anterior cervical intervertebral fusion system (A group), 26 cases received surgical procedure with locking plate combined with intervertebral fusion device (B group). The operation time, blood loss, dysphagia, internal fixation failure were compared between two groups. Incidence of dysphagia, the incidence of internal fixation failure were assessed according to Bazaz dysphagia degree and Japan orthopedic association (JOA) score and X-ray. Results〓All patients were operated successfully and followed up. The average follow-up time was 23.5 months (range, 13-39 months). In A group, the mean operative time was 58±23 min and intraoperative blood loss was 53±25 ml. The Incidence of dysphagia was 26.09%, 8.70%, 0, 0 and 0 in 1, 3, 6, 12 month after operation and the last-time follow-up, respectively. JOA score of A group was 9.18±3.06 preoperatively, which rise up to 15.78±3.21 in 12 months after operation and the improvement rate was 57.15%±29.67%, and no internal fixation failure was found. In team B, the mean operative time was 74±28 min and intraoperative blood loss was 57±19 ml. The Incidence of dysphagia was 46.15%, 26.92%, 11.54%, 3.85% and 0 postoperative at 1 week, 3, 6, 12 months and the last time follow-up, respectively. JOA score was 9.03±3.14 preoperatively, which rise up to 15.34±3.09 after 12 months, and the improvement rate was 58.74%±31.53%. Also there wasn’t any internal fixation failure during follow-up. No significant differences between two groups were found in operation time and incidence of dysphagia in 6 months postoperatively. Conclusion〓Both Zero-p anterior cervical intervertebral fusion system and locking plate combined with cage showed a good clinical effect on cervical spondylosis, while Zero-p anterior cervical intervertebral fusion system had shorter operation time and lower incidence of dysphagia.

Key words: Cervical vertebrae, Spinal fusion, Deglutition diorders

摘要： 【摘要】 目的 比较零切迹颈前路椎间融合固定系统与锁定钢板联合椎间融合器治疗颈椎病的手术时间、术中出血量、吞咽困难发生率、疗效和内固定松动率的差异。方法〓回顾性分析2012年~2014年49例于我院行前路手术的单节段颈椎病病例,A组23例采用零切迹颈前路椎间融合固定系统,B组26例采用锁定钢板联合椎间融合器,随访时间分别为术后1周、3个月、6个月、12个月和末次随访(13~39个月,平均23.5个月),对比分析两组的手术时间、术中出血量、吞咽困难发生率、疗效和内固定松动率,吞咽困难发生率、疗效和内固定松动率分别采用Bazaz吞咽困难分级、JOA评分和X线进行评估。结果〓两组病例均一次性完成手术,无患者失访。A组病例手术时间为58±23 min,术中出血量为53±25 mL,术后1周、3个月、6个月、12个月和末次随访吞咽困难发生率分别为17.39%、4.34%、0、0和0,JOA评分由术前的9.18±3.06分上升至术后12个月的15.78±3.21分,改善率为57.15%±29.67%,至末次随访无内固定松动发生。B组病例手术时间为74±28 min,术中出血量为57±19 mL,术后1周、3个月、6个月、12个月和末次随访吞咽困难发生率分别为46.15%、30.76%、23.08%、0和0,JOA评分由术前的9.03±3.14分上升至术后12个月的15.34±3.09分,改善率为58.74%±31.53%,至末次随访无内固定松动发生。两组对比手术时间和6个月吞咽困难发生率有统计学差异。结论〓零切迹颈前路椎间融合固定系统与锁定钢板联合椎间融合器均可固定牢靠,两者治疗颈椎病均能取得满意的临床疗效,但前者在缩短手术时间和降低吞咽困难发生率上更具优势。

关键词: 颈椎, 脊柱融合术, 吞咽障碍