Objective: To evaluate the safety and effectiveness of applying self-stabilizing zero-profile three-dimensional (3D) printed artificial vertebral bodies in anterior cervical corpectomy and fusion (ACCF) for cervical spondylotic myelopathy.
Methods: A retrospective analysis was conducted on 37 patients diagnosed with cervical spondylotic myelopathy who underwent single-level ACCF using either self-stabilizing zero-profile 3D-printed artificial vertebral bodies ( n=15, treatment group) or conventional 3D-printed artificial vertebral bodies with titanium plates ( n=22, control group) between January 2022 and February 2023. There was no significant difference in age, gender, lesion segment, disease duration, and preoperative Japanese Orthopedic Association (JOA) score between the two groups ( P>0.05). Operation time, intraoperative bleeding volume, hospitalization costs, JOA score and improvement rate, incidence of postoperative prosthesis subsidence, and interbody fusion were recorded and compared between the two groups.
Results: Compared with the control group, the treatment group had significantly shorter operation time and lower hospitalization costs ( P<0.05); there was no significant difference in intraoperative bleeding volume between the two groups ( P>0.05). All patients were followed up, with a follow-up period of 6-21 months in the treatment group (mean, 13.7 months) and 6-19 months in the control group (mean, 12.7 months). No dysphagia occurred in the treatment group, while 5 cases occurred in the control group, with a significant difference in the incidence of dysphagia between the two groups ( P<0.05). At 12 months after operation, both groups showed improvement in JOA scores compared to preoperative scores, with significant differences ( P<0.05); however, there was no significant difference in the JOA scores and improvement rate between the two groups ( P>0.05). Radiographic examinations showed the interbody fusion in both groups, and the difference in the time of interbody fusion was not significant ( P>0.05). At last follow-up, 2 cases in the treatment group and 3 cases in the control group experienced prosthesis subsidence, with no significant difference in the incidence of prosthesis subsidence ( P>0.05). There was no implant displacement or plate-screw fracture during follow-up.
Conclusion: The use of self-stabilizing zero-profile 3D-printed artificial vertebral bodies in the treatment of cervical spondylotic myelopathy not only achieves similar effectiveness to 3D-printed artificial vertebral bodies, but also reduces operation time and the incidence of postoperative dysphagia.
目的: 探讨颈前路椎体次全切减压融合术（anterior cervical corpectomy and fusion，ACCF）中应用自稳定零切迹3D打印人工椎体治疗脊髓型颈椎病的安全性和疗效。.
方法: 回顾性分析2022年1月—2023年2月符合选择标准的37例脊髓型颈椎病患者临床资料。颈前路单个椎体次全切除减压后，15例采用自稳定零切迹3D打印人工椎体行内固定融合（治疗组），22例采用3D打印人工椎体和颈前路钛板行内固定融合（对照组）。两组患者年龄、性别、病变节段、病程以及术前日本骨科协会（JOA）评分等基线资料比较，差异均无统计学意义（ P>0.05）。记录并对比两组手术时间、术中出血量、住院费用、JOA评分及改善率、术后假体下沉发生率、椎间融合情况等指标。.
结果: 与对照组相比，治疗组手术时间缩短、住院费用降低，差异有统计学意义（ P<0.05）；术中出血量组间差异无统计学意义（ P>0.05）。 两组患者均获随访，治疗组随访时间6～21个月，平均13.7个月；对照组6～19个月，平均12.7个月。治疗组术后无患者发生吞咽困难，对照组5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）。术后12个月两组JOA评分均较术前改善（ P<0.05），但两组间JOA评分及改善率差异均无统计学意义（ P>0.05）。影像学复查示，两组均达椎间融合，椎间融合时间差异无统计学意义（ P>0.05）；末次随访时，治疗组2例、对照组3例发生假体下沉，发生率差异无统计学意义（ P>0.05）。随访期间均未发生内植物移位或钛板螺钉断裂。.
结论: 采用自稳定零切迹3D打印人工椎体治疗脊髓型颈椎病，不仅能获得与3D打印人工椎体相似疗效，还能缩短手术时间，降低术后吞咽困难发生率。.
Keywords: Cervical spondylotic myelopathy; anterior cervical corpectomy and fusion; self-stabilization; three-dimensional printed artificial vertebral body; zero-profile.