ACDF联合零切迹椎间融合器治疗脊髓型颈椎病的临床疗效分析

Clinical Efficacy Analysis of ACDF Combined with Zero-Profile Interbody Fusion Device in the Treatment of Cervical Spondylotic Myelopathy

摘要: 目的：评估零切迹椎间融合器应用于颈椎前路椎间盘切除植骨融合术(ACDF)治疗脊髓型颈椎病(CSM)的临床效果，观察术后并发症发生情况。方法：纳入2021年1月至2022年12月期间，在云南中医药大学第一附属医院接受ACDF手术治疗的34例脊髓型颈椎病患者，所有患者使用零切迹椎间融合器。分别评估患者的疼痛VAS评分、椎间隙高度、颈椎Cobb角以及融合节段的Cobb角，并观察术后并发症(如吞咽困难)和植骨融合情况。结果：34例患者术后疼痛VAS评分显著改善，椎间隙高度、颈椎Cobb角和融合节段Cobb角均较术前明显改善。术后2例患者出现吞咽困难，但症状在一周内缓解，最终完全消失。所有患者椎间骨性融合成功，且术后并发症发生率较低。结论：零切迹椎间融合器在ACDF手术中应用具有显著的临床效果，能够改善椎间隙高度、颈椎Cobb角及融合节段的Cobb角，且术后并发症发生率较低。

Abstract: Objective: To evaluate the clinical efficacy of zero-profile interbody fusion devices in anterior cervical discectomy and fusion (ACDF) for the treatment of cervical spondylotic myelopathy (CSM), and to observe the incidence of postoperative complications. Methods: A total of 34 patients with CSM who underwent ACDF using zero-profile interbody fusion devices at the First Affiliated Hospital of Yunnan University of Chinese Medicine from January 2021 to December 2022 were included. The pain visual analogue scale (VAS) score, intervertebral height, cervical Cobb angle, and fusion segment Cobb angle were assessed. The incidence of postoperative complications (e.g., dysphagia) and bone graft fusion were also observed. Results: Postoperatively, the VAS scores for pain significantly improved in all 34 patients. The intervertebral height, cervical Cobb angle, and fusion segment Cobb angle were also significantly better compared to preoperative values. Two patients experienced dysphagia, which resolved within one week and completely disappeared. All patients achieved successful intervertebral bony fusion, with a low incidence of postoperative complications. Conclusion: The use of zero-profile interbody fusion devices in ACDF demonstrates significant clinical efficacy, improving intervertebral height, cervical Cobb angle, and fusion segment Cobb angle, with a low incidence of postoperative complications.