Abstract
ObjectiveTo observe and evaluate the clinical curative effect of a new type of open‐powered cervical spine system developed for anterior cervical surgery.MethodsA retrospective analysis was performed in our hospital in 2015–2017 of 329 orthopaedic patients treated with cervical anterior decompression, cage or titanium mesh graft fusion, new open‐powered nail plate or traditional cervical anterior screw plate. A total of 154 (control group) and 175 (observation group) cases were fixed with conventional cervical‐ and new open‐powered nail plates, respectively. Postoperative follow‐up was performed. Cervical stability, internal fixation position, and bone graft fusion were evaluated by imaging. Operative time, intraoperative blood loss, cervical Cobb angle, pain visual analogue scale (VAS) score, and Japanese orthopaedic association (JOA) score were compared between the groups. JOA scoring (spinal cord function) and neurological function improvement rate (IR) were used to assess clinical efficacy.ResultsThe patients were followed up for 8–36 months with an average of 19.48 months. There was no significant difference in the operation time and intraoperative blood loss between the two groups (P > 0.05). In the control group, the Cobb angles of the cervical spine were 5.13° ± 1.28°, 10.46° ± 1.07°, and 9.72° ± 1.43° before and after the operation. The observation group was followed by the Cobb angle of the cervical spine before and after the operation. They were 4.96° ± 1.39°, 11.67° ± 0.93°, and 11.13° ± 1.19°, respectively; the JOA scores before the operation, 1 week after the operation, and at the last follow‐up were (8.07 ± 1.13) points and (13.57 ± 0.82) points, and (14.19 ± 0.96) points, respectively; the IR was 86.52% ± 9.33%. The preoperative, postoperative 1 week, and last follow‐up JOA scores in the observation group were (8.37 ± 1.29) points, (14.11 ± 0.93) points, and (14.95 ± 0.78) points respectively. The IR was 88.74% ± 8.16% in the scores; the VAS scores were (5.54 ± 0.89) points, (1.73 ± 0.71) points, and (1.48 ± 0.52) points in the preoperative, postoperative 1 week, and last follow‐up in the control group. The VAS scores were (5.81 ± 0.94) points, (1.82 ± 0.61) points, and (1.16 ± 0.49) points before, 1 week, and after the final follow‐up. The JOA score and IR, VAS score and preoperative comparison between the two groups were statistically significant (P < 0.05), but there was no statistically significant difference between the two groups (P > 0.05).ConclusionThe new open‐powered nail anterior cervical plate system can achieve the same clinical effect as the traditional anterior cervical plate fixation in anterior cervical surgery, but it can simplify the operation process, effectively make up for the shortcomings of the traditional anterior cervical plate operation, and obtain satisfactory clinical application effect, which is worthy of clinical promotion.
Highlights
With social development, the incidence rates of cervixrelated diseases such as cervical spondylosis and traumatic fractures are gradually increasing due to changes in lifestyle and work methods; in turn, these ailments are gradually becoming common clinical issues
The new open-powered nail anterior cervical plate system can achieve the same clinical effect as the traditional anterior cervical plate fixation in anterior cervical surgery, but it can simplify the operation process, effectively make up for the shortcomings of the traditional anterior cervical plate operation, and obtain satisfactory clinical application effect, which is worthy of clinical promotion
The upper plate is fixed without removing the distraction nail, the titanium C-shaped opening side is directly inserted into the special opening nail, and the nail is set in a stable and pressurized state, which ensures pressurization and means it can be controlled accurately (Fig. 3)
Summary
The incidence rates of cervixrelated diseases such as cervical spondylosis and traumatic fractures are gradually increasing due to changes in lifestyle and work methods; in turn, these ailments are gradually becoming common clinical issues For such diseases, many patients with ineffective conservative treatment and severe spinal cord injury are currently treated by surgery. Since Robinson and Smith[1] first used anterior cervical surgery to treat cervical spondylosis in the 1960s, after a long period of clinical practice, anterior cervical surgery has become a classic operation to treat cervical-related diseases This kind of operation can directly reduce the pressure in front of the spinal cord, such as the degenerative intervertebral disc, and at the same time provide strong fixation through cage or titanium mesh bone graft and anterior cervical internal fixation plate system, maintaining the stability of the cervical spine after operation and improving the physiological curvature of the cervical spine[2,3]. Common complications such as spinal cord injury, nerve damage, vascular injury, lung injury, esophageal injury, cerebrospinal fluid leakage, formation of epidural hematoma, and failure of internal organs, often result in surgical failure[5–8]
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