关键词: 颈椎前路椎间盘切除术, zero-P, 吞咽困难, 临床护理

Abstract:

Objective　To comparatively study the clinical efficacy and dysphasia of anterior cervical discectomy with plate fixation and Zero-profile implantation in a prospective study method.　Methods　134 cases had been divided randomly into two groups from December, 2009 to February, 2013 according to the inclusion criteria. 71 cases in ACDF group underwent anterior discectomy and interbody fusion with plate internal fixation; 63 cases in group Zero-Profile underwent anterior discectomy and Zero-Profile implantation. All patients had different degrees of neck and shoulder pain, limb pain and numbness and weakness, of which 68 cases complained of feeling of trunk banding and double lower limbs on cotton, and 12 cases complained of mild defecation dysfunction. Single segment operation time, intraoperative bleeding volume, images of pre-operation and post-operation in both groups were compared; VAS, JOA, D value and SWAL-QOL score were assessed.　Results　All cases were followed up. Follow-up time was 8-24 months with an average (13±2.5) months. The average operation time of each segment in the ACDF and Zero-p groups was (65±11.3) min and (47±7.6) min, respectively; the average bleeding volume of each segment was (68.5±21.1) ml and (42.7±14.4) ml, respectively; the average hospital stay was 5.4 days and 4.2 days, respectively. Display: Zero-p group were lower than that in the ACDF group and there was significant difference. no implant subsidence or collapse, screw loosening was found in the two groups;, all patients showed evidence of bony fusion.　Conclusions　The model of zero notch implant system has the advantages of being simple in operation, short in operation time, mild in bleeding and early in clinical curative effect; this fixation system theorectically can effectively reduce complications caused by the steel structure, especially the common postoperative dysphasia; Hence, it is an effective alternative implant fixation for the anterior cervical plate.

Key words: Anterior cervical discectomy, Zero-profile, Dysphasia, Clinical nursing