| Objectives:The study aims to retrospectively analyze the data of patients undergoing anterior cervical spine surgery with two different internal fixation methods to investigate the clinical efficacy and superiority of anterior cervical self-locking bridge cage(ROI-C)and titanium plate with cage in the treatment of single segment cervical disc herniation.Method:54 patients including 27 males and 27 females who had undergone anterior cervical fusion for degenerative cervical diseases and had at least 1.5 years of follow-up in our hospital from May 2013 to December 2014 were enrolled.Simple random grouping,Totally 23 patients used ROI-C as an internal plant were divided into group A(12 males and 11 females),the average patient age at the time of surgery was(49.78±10.40)years old and the average follow-up period was(16.17±2.19)months.The other 31 patients treated with interbody fusion cage and anterior titanium plate were recruited in group B(15 males and 16 females).The average patient age at the time of surgery was(45.54± 10.22)years and the average follow-up period was(15.39±2.51)months.Careful physical and radiological examination,including plain radiography and MRI,were performed pre-operatively in all patients.The preoperative conditions,operation time,intraoperative blood loss,Odom function rating,Japanese Orthopedic Association(JOA)score,and visual analogue scale(VAS)score before and after surgery were compared between the two groups as well.Cervical lordosis(Cobb angle),anterior lordosis of the infused segment,interbody fusion rate,postoperative dysphagia(Bazas score),incidence of adjacent segment degeneration were compared between two groups.The paired t-test was used for the comparsion of the JOA score and the neck pain VAS score.The data of the inter-group study were compared using the t-test or the X2 test.Result:The average follow-up time of all the 54 patients was 15.7±2.4 months.There were no significant differences in age,sex ratio,follow-up time,surgical segment,preoperative visual analog scale(VAS)score,Japanese Orthopedic Association(JOA)scores and operation time between the 2 groups(P>0.05).There was a statistically difference in intraoperative blood loss between the two groups(P<0.01).There was no significant difference in Odom function scores between the two groups before and after surgery(P>0.05).The JOA scores and the VAS scores of the two groups were higher and lower than the preoperative scores at 3 months and the last follow-up respectively(P<0.05).The cervical lordosis angle of the two groups was significantly higher than that before the operation(P<0.05).In group A,2 patients had mild dysphagia,and the incidence of postoperative dysphagia was 9%(2/23),however,there were 11 cases of dysphagia in group B,and the incidence of postoperative dysphagia was 35%(11/31).The incidence of postoperative dysphagia in the two groups was statistically significant(P<0.05).At the last follow-up,all patients received bony fusion,and no obvious loosening or sinking of the built-in material was observed.There was no significant difference in vertebral fusion rate between the two groups(P>0.05).In the last follow-up of group A,there were 3 cases of adjacent segment degeneration,and the rate of degeneration was 13%,In the last follow-up of group B,8 patients had adjacent segment degeneration,and the rate of degeneration was 26%,However,there was no statistically significant difference between the two groups.Conclusion:The clinical efficacy of intervertebral bridge fusion device in anterior cervical decompression is similar to that of traditional titanium plate combined cage,but the former has advantages of easier operational skills,less intraoperative blood loss,less trauma and low incidence of long-term postoperative dysphagia,which is worthy of clinical promotion. |
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