【摘要】 目的 探讨零切迹桥形锁定融合器（ROI-C）与钛板-椎间融合器（PCC）系统治疗单节段脊髓型颈椎病的疗效差异以及两种内固定材料对颈椎矢状位参数及其变化值的影响。方法 回顾性分析2018年3月至2021年3月在郑州大学第一附属医院接受手术治疗的37例（ROI-C组21例，PCC组16例）脊髓型颈椎病患者的病历资料。评价指标包括疼痛视觉模拟（VAS）评分、日本骨科学会（JOA）评分、颈椎功能障碍指数（NDI）、颈椎矢状位参数和吞咽困难评分等。比较分析两组各项临床指标和矢状位参数的差异及相关性。结果 在37例患者中ROI-C组手术时间较PCC组短，术中出血量较PCC组少，但手术时间及术中出血量的差异无统计学意义（P>0.05）。末次随访时两组VAS评分、JOA评分、NDI均较术前改善（P<0.05）,PCC组较ROI-C组JOA评分更高，VAS评分、NDI更低，但组间差异无统计学意义（P>0.05）。PCC组较ROI-C组提供更好的责任节段前柱高度变化值及颈椎曲度变化值（P<0.05）,两组术后C₂矢状面垂直轴及责任节段前柱高度保持在同一范围内。ROI-C组术后发生吞咽困难1例（4.7%,1/21）,PCC组发生吞咽困难6例（37.5%,6/16）,差异有统计学意义（P=0.029）。结论 基于ROI-C及PCC系统的前后路联合手术都能有效地改善相关症状并在短期内维持颈椎矢状位平衡，PCC组责任节段前柱高度改变值及颈椎曲度改变值更大，ROI-C能减少术后并发症的发生。更多还原

【Abstract】 Objective To investigate the effect difference between zero-profile stand-alone cervical cage（ROI-C） and plate-cage construct（PCC） system in the treatment of single-level cervical spondylotic myelopathy and the effect of two kinds of internal fixation materials on cervical sagittal parameters and their changes.Methods A retrospective analysis was performed on the medical records of 37 patients（21 in the ROI-C group and 16 in the PCC group） with cervical spondylotic myelopathy who received surgical treatment in the First Affiliated Hospital of Zhengzhou University from March 2018 to March 2021. The evaluation indexes included visual analogue scale（VAS） score, Japanese Orthopaedic Association（JOA） score, neck disabilitv index（NDI）, cervical sagittal parameters and dysphagia score. The difference and correlation of clinical indexes and sagittal parameters between the two groups were compared and analyzed.Results In 37 patients, the operation time of ROI-C group was shorter than that of PCC group, the amount of intraoperative blood loss was less than that of PCC group, but there were no statistical difference in operative time and intraoperative blood loss（P>0.05）. At the last follow-up, VAS score, JOA score and NDI of the two groups were improved compared with that before surgery（P<0.05）. Compared with the ROI-C group, JOA score of the PCC group was higher, and VAS score and NDI were lower, but there was no statistical difference between the two groups（P>0.05）. Compared with the ROI-C group, the PCC group provided better changes in the height of the anterior column of responsibility and cervical curvature（P<0.05）, and the vertical axis of C₂ sagittal plane and the height of the anterior column of the responsible segment remained in the same range in the two groups. Postoperative dysphagia occurred in 1 case（4.7%, 1/21） in the ROI-C group and 6 cases（37.5%, 6/16） in the PCC group, with statistically significant difference（P=0.029）.Conclusion The combined posterior and anterior approach based on ROI-C and PCC system can effectively improve the symptoms and maintain the sagittal balance of the cervical spine in the short term. The changes in the height of the anterior column of responsibility and the curvature of the cervical spine in the PCC group are larger, and the ROI-C can reduce postoperative complications.更多还原