目的 比较新型自锁式颈椎融合器ROI-C与前路钛板固定联合cage植骨融合治疗老年性脊髓型颈椎病的安全性. 方法 回顾性分析我院从2012年1月至2013年9月收治的58例脊髓型颈椎病患者,其中行颈椎前路减压ROI-C融合器椎间融合的患者23例( ROI-C融合器组) ,行前路钛板内固定联合cage椎间融合的患者35例(钛板+cage组) ,对比两组患者的手术时间、术中出血量、术后复苏时间、术后住院时间,随访常规复查颈椎正侧位X线片并观察有无感染、食管损伤破裂、术后吞咽困难以及植入物移位、松动、断裂等并发症. 结果 ROI-C融合器组在手术时间、术中失血量、术后住院时间方面明显低于钛板+cage组,其差异存在统计学意义(P<0. 05). 术后平均随访14. 1个月(12. 0~22. 0个月) ,ROI-C融合器组1例发生吞咽困难,钛板+cage组9例发生吞咽困难,两组吞咽困难发生率差异有统计学意义(P<0. 05). 两组均未见手术节段不稳. 结论 采用ROI-C融合器行椎间融合较前路钛板联合cage植骨融合在减少术中出血、缩短手术时间及术后住院时间、降低吞咽困难等术后并发症方面更具优势,值得临床加大推广应用.%Objective To compare the security of ROI-C implant vs. titanium plate with cage fixation for cervical spondylotic myelopathy in the elderly. Methods Data of 58 patients with cervical spondylotic my-elopathy who underwent anterior cervical discectomy and fusion by ROI-C (n=23) or traditional titanium plate with cage fixation (n=35) between Jan. 2012 and Sep. 2013 were retrospectively analyzed. Operative time, intraoperatve blood loss, recovery time and hospitalization stay after operation, dysphagia incidence and other complications in both groups were measured and compared. Results Operative time, intraoperatve blood loss and hospitalization stay after operation were significant different between the two groups (P<0. 05). The aver-age follow-up period was 14. 1 months (range of 12. 0 months to 22. 0 months). One patients in ROI-C group and 9 in titanium plate with cage group suffered from dysphagia after surgery (P<0. 05). Conclusion Opera-tive time, intraoperatve blood loss, hospitalization stay and dysphagia rate after operation are reduced in ROI-C as compared with those in titanium plate with cage for cervical spondylotic myelopathy in the elderly.
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