Abstract: Objective To observe the clinical effect of Zero profile anterior cervical interbody fusion in treating of the single segmental cervical spondylotic myelopathy （CSM） and analyze the operative characteristics. Methods Twenty-three patients with single segmental CSM were treated by Zero profile anterior cervical interbody fusion. Clinical outcome according to VSA and JOA scoring system,Dysphagia, lordosis angle of cervical spine and intervertebral space angle and height on radiographs were recorded preoperatively and postoperatively. Results All patients were followed up for an average of 12 months. The average cervical and limb VAS score decreased from 3.2±1.5, 6.5±1.6 preoperatively to 2.8±1.6, 1.2±0.7 at the final follow-up; the average JOA score increased from 9.4±1.9 preoperatively to14.8±1.9 at the final follow-up. The good to excellent rate was 100%. The intervertebral height and Cobbs angle in the immediate postoperative and the last follow-up were significantly increased compared to preoperation. Conclusion Zero profile ACDF in treating of the single segmental CSM is a good technique which can effectively maintain the physiological vertebral lordosis and intervertebral height, provide long time stability and achieve satisfactory clinical results with less injury.

Key words: spinal fusion, zero profile anterior cervical interbody fusion cage, cervical spondylotic myelopathy

摘要： 目的 探讨ZERO-P钢板应用于单节段脊髓型颈椎病（CSM）治疗的手术特点和近期临床疗效。方法 23例脊髓型颈椎病患者采用颈椎前路椎间盘髓核摘除、减压、零切迹钢板固定并椎间融合术,分析手术过程特点,对比手术前后、末次随访的吞咽情况,临床疗效（VAS和JOA评分）及术后融合节段椎间隙高度、Cobb氏角变化,判断椎间稳定情况及椎间融合率。结果 手术时间85.8±26.6 min;术中失血83.7±32.7 mL。术后吞咽困难发生率13%。术后随访12月,23例患者术前颈及上肢VAS评分分别为3.2±1.5分、6.5±1.6分,JOA评分9.4±1.9分,末次随访颈及上肢VAS评分2.8±1.6分,1.2±0.7分,JOA评分14.8±1.9分,JOA评分术后改善率：优20例,良3例,优良率100%。术后1周和末次随访与术前相比融合节段椎间隙高度和Cobb氏角度明显改善（P<0.001）,术后1周与末次随访比较无明显间隙高度和角度丢失（P>0.05）,随访过程中未发现内固定螺钉松动、移位,末次随访颈椎动力位片判断椎间稳定率100%。结论 ZERO-P钢板单独应用于单节段脊髓型颈椎病的治疗的手术创伤小,操作简单,并发症低,并可有效改善和维持颈椎的病变节段生理曲度和间隙高度,临床近期疗效满意。

关键词: 零切迹颈前路椎间融合器, 脊髓型颈椎病, 椎间融合