颈椎病
减压
Oswestry残疾指数
随机对照试验
作者
Bin Sun,Shi Changgui,Huiqiao Wu,Zeng Xu,Wenbo Lin,Xiaolong Shen,Xiaodong Wu,Ying Zhang,Wen Yuan
出处
期刊:Spine
[Ovid Technologies (Wolters Kluwer)]
日期:2020-04-15
卷期号:45 (8): 504-511
被引量:3
标识
DOI:10.1097/brs.0000000000003312
摘要
STUDY DESIGN A retrospective study. OBJECTIVE To assess the long-term results of zero-profile spacer for 3-level anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA Although widely used, there are still controversies about the long-term results of zero-profile spacer, especially in multilevel cases. METHODS Cases received 3-level ACDF for cervical spondylotic myelopathy (CSM) using either zero-profile spacer (n = 27) (ZP Group), or plate and cages (n = 34) (PC Group), and with 5-year follow-up were reviewed. Neurological function and life quality were assessed by modified Japanese Orthopaedic Association (mJOA) score, Neck Disability Index (NDI), and Short-Form 36 (SF-36) score. Disc height, cervical lordosis, fusion rate, and surgical complications were observed. RESULTS Neurological recovery and life quality improvement were similar in both groups. Disc height and cervical lordosis (C2-7 Cobb angle) were well restored after operations, but lost in both groups during follow-up. Loss of correction (LOC) in disc height was larger in ZP Group (11.38% vs 5.71%, P < 0.05) at 5-year follow-up. LOC of cervical lordosis in ZP group constantly grew from 11.28% to 48.13% during 5-year follow-up, significantly higher than that in the PC group (from 7.43% to 14.01%) (P < 0.05). The rate of postoperative dysphagia was no statistical difference between the two groups, and symptoms were all disappeared within 1 year. There were 10 levels of adjacent segment degeneration (1 in ZP Group, and 10 in PC Group, P = 0.02). Cage subsidence (11 of 81 levels, 13.58%) and screw migration (2 of 81 levels, 2.47%) were only observed in the ZP Group. The migrated screws in one case were surgically removed. Fusion was achieved in all cases. CONCLUSIONS In long-term follow-up of 3-level ACDF for CSM, zero-profile spacer has the similar clinical results, but loss of correction of disc height and cervical alignment were significantly higher, compared with anterior plate and cages. LEVEL OF EVIDENCE 3.
科研通智能强力驱动
Strongly Powered by AbleSci AI