Comparison Of Curative Effect Between Zero-profile Bridge-shaped Locking Cage And Traditional Titanium Plate Interbody Cage In The Treatment Of Cervical Spondylotic Myelopathy

ObjectiveTo investigate the difference in curative effect between zero-profile bridge-shaped locking cage(ROI-C)and traditional titanium plate interbody cage in the treatment of cervical spondylotic myelopathy.MethodsA total of 126 patients(55 males and 71 females)with continuous double-level and three-level cervical spondylotic myelopathy who received surgical treatment in the Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University from June 2017 to June 2019 were retrospectively analyzed.There were 88 cases of two levels and 38 cases of three levels.66 patients were treated with ROI-C and 60 patients were treated with traditional titanium plate interbody cage.General data included age,duration of surgery,amount of blood loss,surgical level,follow-up time,and evaluation of cervical Cobb angle,mean interbody height of fusion level,visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA)scores.The postoperative recovery was evaluated by Odom standards one year after surgery.The incidence of postoperative complications such as sore throat,dysphagia,adjacent segment degeneration(ASD),fusion device sinking and axial symptoms were recorded in the two groups.ResultsThe amount of intraoperative blood loss in the ROI-C group was less than that in the titanium plate group(P<0.05),and the operation time of three segments in the ROI-C group was less than that in the titanium plate group with statistical significance(P<0.05).Imaging results:The cervical Cobb angle of the double-segment patients in the ROI-C group was smaller than that in the titanium plate group at 3 months and 1 year after operation,and the differences were statistically significant(P<0.05).There was no significant difference in cervical Cobb angle between the two groups of three-segment patients(P>0.05).In ROI-C group,the average height of the intervertebral segment of the two-segment fusion segment at 1 year and 2 years after surgery and the average height of the fusion segment of the three-segment patient at 3 months and 2 years after surgery were higher than those in the titanium plate group,and the differences were all statistical significance(P<0.05).Clinical evaluation results:The VAS score of the two-segment patients in the ROI-C group was lower than that in the titanium plate group at 2 years after operation,and the difference was statistically significant(P<0.05).The JOA score of the double-segment patients in the ROI-C group was better than that in the titanium plate group at 1 year after surgery,and the difference was statistically significant(P<0.05).One year after operation,the improvement rate of JOA in the ROI-C group was(80.12%±8.60%),which was better than that in the titanium plate group(77.21%±7.42%),and there was a significant difference between the two groups(P<0.05).Complications:one week after surgery,there was 1 case of dysphagia in ROI-C group and 10 cases in titanium plate group,the difference between the two groups was statistically significant(P<0.05).The incidence of segmental dysphagia 1 week after operation in plate group was higher than that in double-segment patients(P<0.05).There was no significant difference in the incidence of ASD between 2 groups(P>0.05).Axial symptoms occurred in 2 patients in the titanium plate group and 0 patients in the ROI-C group,and there was no significant difference between the two groups(P>0.05).Conclusion1.Both immobilization methods can significantly relieve the symptoms of patients,restore the curvature of the cervical spine,and improve the function of spinal nerves,and have achieved good short-term clinical effects.2.Using ROI-C can reduce the amount of bleeding,shorten the operation time,and reduce the incidence of postoperative dysphagia.