{"title":"比较两颗螺钉与四颗螺钉内固定对颈椎前路椎间盘切除术和融合术融合速度的影响：一项前瞻性随机对照试验。","authors":"Cheng-Yi Huang, Xia-Qing Sheng, Xing-Jin Wang, Zi-Han Peng, Ting-Kui Wu, Kangkang Huang, Yang Meng","doi":"10.1097/BRS.0000000000005334","DOIUrl":null,"url":null,"abstract":"<p><strong>Background context: </strong>The insertion process of the new two-screw internal fixation is simpler than that of four-screw internal fixation for anterior cervical discectomy and fusion (ACDF). However, it is unclear whether there is a difference in fusion rate.</p><p><strong>Purpose: </strong>This study aimed to compare the time required to achieve osseous fusion and the clinical efficacy of four-screw versus two-screw internal fixation.</p><p><strong>Study design: </strong>Prospective randomized controlled trial.</p><p><strong>Patient sample: </strong>From October 2021 to April 2023, eighty patients diagnosed with single-level cervical spondylosis were recruited and randomly allocated into a four- or two-screw group.</p><p><strong>Outcome measures: </strong>The primary endpoint was the fusion rate six months postoperatively. Secondary outcomes included the prevalence of complications and patient-reported outcome measures (PROMs), including the Japanese Orthopaedic Association score, Neck Disability Index, and visual analog scale scores for arm and neck pain.</p><p><strong>Methods: </strong>Patients were randomized to receive four-screw internal fixation (n=40) or two-screw internal fixation (n=40).</p><p><strong>Results: </strong>A total of 77 patients completed the trial and were included in the analysis. No significant differences were observed between groups at baseline. The fusion rate in the two-screw group was significantly higher than that in the four-screw group (69.2% vs. 42.1%, P=0.022) at six months postoperatively. No significant difference was found in the fusion rates at 3 and 12 months postoperatively between groups. Overall, PROMs significantly improved after surgery in both groups and did not differ significantly between groups at any follow-up time point. The prevalence of complications was not significantly different between groups.</p><p><strong>Conclusions: </strong>Two-screw internal fixation can achieve osseous fusion faster than four-screw internal fixation in ACDF. Two-screw internal fixation seems to achieve the same PROMs and safety as four-screw internal fixation.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Two-Screw versus Four-Screw Internal Fixation on Fusion Speed in Anterior Cervical Discectomy and Fusion: A Prospective Randomized Controlled Trial.\",\"authors\":\"Cheng-Yi Huang, Xia-Qing Sheng, Xing-Jin Wang, Zi-Han Peng, Ting-Kui Wu, Kangkang Huang, Yang Meng\",\"doi\":\"10.1097/BRS.0000000000005334\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background context: </strong>The insertion process of the new two-screw internal fixation is simpler than that of four-screw internal fixation for anterior cervical discectomy and fusion (ACDF). However, it is unclear whether there is a difference in fusion rate.</p><p><strong>Purpose: </strong>This study aimed to compare the time required to achieve osseous fusion and the clinical efficacy of four-screw versus two-screw internal fixation.</p><p><strong>Study design: </strong>Prospective randomized controlled trial.</p><p><strong>Patient sample: </strong>From October 2021 to April 2023, eighty patients diagnosed with single-level cervical spondylosis were recruited and randomly allocated into a four- or two-screw group.</p><p><strong>Outcome measures: </strong>The primary endpoint was the fusion rate six months postoperatively. Secondary outcomes included the prevalence of complications and patient-reported outcome measures (PROMs), including the Japanese Orthopaedic Association score, Neck Disability Index, and visual analog scale scores for arm and neck pain.</p><p><strong>Methods: </strong>Patients were randomized to receive four-screw internal fixation (n=40) or two-screw internal fixation (n=40).</p><p><strong>Results: </strong>A total of 77 patients completed the trial and were included in the analysis. No significant differences were observed between groups at baseline. The fusion rate in the two-screw group was significantly higher than that in the four-screw group (69.2% vs. 42.1%, P=0.022) at six months postoperatively. No significant difference was found in the fusion rates at 3 and 12 months postoperatively between groups. Overall, PROMs significantly improved after surgery in both groups and did not differ significantly between groups at any follow-up time point. The prevalence of complications was not significantly different between groups.</p><p><strong>Conclusions: </strong>Two-screw internal fixation can achieve osseous fusion faster than four-screw internal fixation in ACDF. Two-screw internal fixation seems to achieve the same PROMs and safety as four-screw internal fixation.</p>\",\"PeriodicalId\":22193,\"journal\":{\"name\":\"Spine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-03-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BRS.0000000000005334\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005334","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景背景：在颈椎前路椎间盘切除术融合术（ACDF）中，新型双螺钉内固定的置入过程比四螺钉内固定更简单。然而，目前尚不清楚聚变速率是否有差异。目的：本研究旨在比较四螺钉与两螺钉内固定实现骨融合所需的时间和临床疗效。研究设计：前瞻性随机对照试验。患者样本：从2021年10月至2023年4月，招募80例诊断为单节段颈椎病的患者，随机分为四螺钉组和双螺钉组。结果测量：主要终点是术后6个月的融合率。次要结局包括并发症的发生率和患者报告的结局测量（PROMs），包括日本骨科协会评分、颈部残疾指数和手臂和颈部疼痛的视觉模拟量表评分。方法：患者随机分为四螺钉内固定组（n=40）和双螺钉内固定组（n=40）。结果：共有77例患者完成试验并纳入分析。基线时各组间无显著差异。术后6个月，双螺钉组的融合率明显高于四螺钉组（69.2% vs 42.1%， P=0.022）。两组术后3个月和12个月的融合率无明显差异。总体而言，两组术后PROMs均有显著改善，在任何随访时间点，两组间无显著差异。两组间并发症发生率无明显差异。结论：双螺钉内固定比四螺钉内固定能更快实现ACDF的骨融合。双螺钉内固定似乎可以达到与四螺钉内固定相同的prom和安全性。
Comparison of Two-Screw versus Four-Screw Internal Fixation on Fusion Speed in Anterior Cervical Discectomy and Fusion: A Prospective Randomized Controlled Trial.
Background context: The insertion process of the new two-screw internal fixation is simpler than that of four-screw internal fixation for anterior cervical discectomy and fusion (ACDF). However, it is unclear whether there is a difference in fusion rate.
Purpose: This study aimed to compare the time required to achieve osseous fusion and the clinical efficacy of four-screw versus two-screw internal fixation.
Study design: Prospective randomized controlled trial.
Patient sample: From October 2021 to April 2023, eighty patients diagnosed with single-level cervical spondylosis were recruited and randomly allocated into a four- or two-screw group.
Outcome measures: The primary endpoint was the fusion rate six months postoperatively. Secondary outcomes included the prevalence of complications and patient-reported outcome measures (PROMs), including the Japanese Orthopaedic Association score, Neck Disability Index, and visual analog scale scores for arm and neck pain.
Methods: Patients were randomized to receive four-screw internal fixation (n=40) or two-screw internal fixation (n=40).
Results: A total of 77 patients completed the trial and were included in the analysis. No significant differences were observed between groups at baseline. The fusion rate in the two-screw group was significantly higher than that in the four-screw group (69.2% vs. 42.1%, P=0.022) at six months postoperatively. No significant difference was found in the fusion rates at 3 and 12 months postoperatively between groups. Overall, PROMs significantly improved after surgery in both groups and did not differ significantly between groups at any follow-up time point. The prevalence of complications was not significantly different between groups.
Conclusions: Two-screw internal fixation can achieve osseous fusion faster than four-screw internal fixation in ACDF. Two-screw internal fixation seems to achieve the same PROMs and safety as four-screw internal fixation.
期刊介绍：
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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