摘要
目的了解颈椎前路椎间盘切除减压、植骨融合术(ACDF)后椎前软组织肿胀与吞咽困难的关联,比较分析颈椎前路Zero-p椎间融合术和传统的Cage钛板融合术后椎前软组织肿胀程度和吞咽困难的发生率。方法选择2013年5月至2015年5月我科收治的单节段(C5/6)脊髓型颈椎病患者54例,其中25例患者采用Zero-p椎间融合术治疗(Zero-p组),29例患者采用传统的Cage钛板融合术治疗(Cage组);通过颈椎侧位X射线片测量患者术前、术后椎前软组织的宽度,根据肿胀程度,将患者分为肿胀组(24例)和非肿胀组(30例),比较分析2组患者吞咽困难的发生情况。比较Zero-p组和Cage组术后椎前软组织肿胀程度及吞咽困难的发生率。结果肿胀组术后吞咽困难发生率为45.8%,高于非肿胀组的13.3%,差异有统计学意义(P<0.05);Zero-p组术后椎前软组织肿胀平均为6.22 mm,低于Cage组的9.25 mm,差异有统计学意义(P<0.05);Zero-p组术后吞咽困难的发生率为12.0%,低于Cage组的41.4%,差异有统计学意义(P<0.05)。结论颈椎ACDF术后椎前软组织肿胀程度较高的患者术后吞咽困难的发生率也较高。颈椎前路Zero-p椎间融合术治疗单节段(C5/6)脊髓型颈椎病较传统的Cage钛板融合术后椎前软组织肿胀程度及吞咽困难的发生率低。
Objective To explore the relationship among the prevertebral soft tissue swelling and dysphagia rate after anterior cervical diskectomy and fusion（ ACDF）,and to investigate the prevertebral soft tissue swelling and dysphagia rate after Zero-p or traditiona I cage and titanium plate for one-level lesion of cervical myelopathy. Methods The clinical data of 54 patients with one-level lesion（ C5/6） of cervical myelopathy who undelwent anterior cenrical discectomy and fusion by Zero-p（ n = 25） or traditional cage and titanium plate（ n = 29） were analyzed. The postoperative prevertebral soft tissue swelling was measured by lateral radiographs. Patients were divided into the swelling group（ n = 24） and the non-swelling group（ n = 30） based on the degree of prevertebral soft tissue swelling and the incidences of dysphagia were analyzed. Patients were divided into the Zero-p group（ n = 25） and the Cage group（ n = 29） based on surgical treatment,the postoperative prevertebral soft tissue swelling and dysphagia rate were compared. Results The rate of dysphagia in swelling group was 45. 8%,which was higher than 13. 3% in non-swelling group,the difference was significant（ P〈0. 05）. The postoperative prevertebral soft tissue swelling was 6. 22 mm averagely after Zreo-p,which was less than that after traditional cage and titanium plate for anterior cervical discectomy with fusion（ 9. 25 mm）,the difference was significant（ P〈0. 05）. The incidence of dysphagia in Zero-p group was 12%,which was lower than 41. 4% in Cage group,and the difference was statistically significant（ P〈0. 05）. Conclusion It is a clinical significance to evaluate the degree of prevertebral soft tissue swelling by cervical lateral X-ray after ACDF,when the degree of prevertebral soft tissue swelling is greater,the incidence of complications such as dysphagia is higher. In addition,The Zero-p for the treatment of single one-level lesion of cervical myelopathy（ C5/6） has a lower degree of prevertebral soft tissue swelling and dysphagia rate than the traditional Cage and titanium plate fusion.
出处
《局解手术学杂志》
2018年第1期12-15,共4页
Journal of Regional Anatomy and Operative Surgery
基金
辽宁省科学基金项目(2014225012)
中国博士后科学基金面上项目(2015M582821)
关键词
脊髓型颈椎病
Zero-p
软组织损伤
吞咽困难
椎间融合术
cervical spondylotic myelopathy
Zero-p
prevertebral soft tissue swelling
dysphagia
interbody fusion
作者简介
[通信作者]项良碧，E-mail：xiangliangbi1963@sina．com
