目的 对比分析零切迹椎间融合器与椎间融合器联合钛板应用于颈椎前路椎间盘切除融合术（ACDF）的临床疗效和影像学差异。 方法 回顾性分析2017年2月至2021年11月期间收治的40例行ACDF患者的临床资料，其中22例采用零切迹椎间融合器（零切迹组），18例采用椎间融合器联合钛板（钛板组）。记录两组患者的手术时间及术中出血量；采用日本骨科学会评分（JOA）、颈椎功能障碍指数（NDI）评分及术后吞咽困难发生情况评估临床疗效；测量颈椎Cobb角（C_2-7）、融合节段Cobb角、平均椎间隙高度、融合节段高度；通过术后CT观察融合器内外骨桥接情况评估融合情况及融合器下沉情况。 结果 两组的手术时间、术中出血量差异无统计学意义（P > 0.05）；两组术后的JOA评分、NDI评分、平均椎间隙高度及融合节段高度均较术前显著改善（P < 0.05），零切迹组术后吞咽困难发生率显著低于钛板组（P < 0.05），术后3个月零切迹组的融合节段Cobb角较术前显著改善（P < 0.05）；除术后3个月及末次随访时两组融合节段Cobb角的差异有统计学意义（P < 0.05）和末次随访时两组融合器外骨桥接（ExGBB）的差异有统计学意义（P < 0.05）外，各随访时间点其余影像学指标两组差异均无统计学意义（P > 0.05）。 结论 在ACDF中，零切迹椎间融合器和椎间融合器联合钛板治疗临床疗效相似，均能显著改善颈椎功能及术后影像学指标，但零切迹椎间融合器较椎间融合器联合钛板显著降低吞咽困难发生率；终末期随访，前者对融合节段Cobb角的改善效果及其ExGBB情况优于后者，更有利于促进植骨融合；两种融合器均有发生下沉的风险。

Objective Compare and analyze the clinical efficacy and imaging differences of zero?profile interbody fusion cage and interbody fusion cage combined with titanium plate in anterior cervical discectomy and fusion （ACDF）. Methods The clinical data of 40 patients who underwent ACDF in our hospital from February 2017 to November 2021 were retrospectively analyzed. Among them， 22 patients were treated with zero?profile interbody fusion cage （zero?profile group）， and 18 patients were treated with interbody fusion cage combined with titanium plate （titanium plate group）. Record the operation time and intraoperative blood loss of the two groups. Japanese Orthopaedic Association （JOA） score， neck disability index （NDI） score and postoperative dysphagia were used to evaluate the clinical efficacy. Measure the cervical Cobb angle （C2?C7）， fusion segment Cobb angle， average intervertebral space height， and fusion segment height. Evaluate the fusion and subsidence of the cage by observing the internal and external bone bridging of the cage through postoperative CT. Results There was no significant difference in operation time and intraoperative blood loss between the two groups （P > 0.05）. The JOA score， NDI score， average intervertebral space height， and fusion segment height of the two groups after operation were significantly improved compared with those before operation （P < 0.05）. The incidence of postoperative dysphagia in the zero?profile group was significantly lower than that in the titanium plate group （P < 0.05）. The Cobb angle of the fusion segment in the zero?profile group at 3 months after operation was significantly improved compared with that before operation （P < 0.05）. There was no significant difference in the other radiographic parameters between the two groups at each follow?up time point （P > 0.05）， except for the Cobb angle of the fusion segment at 3 months after operation and at the last follow?up （P < 0.05） and the difference in the extra?fusion bone bridge （ExGBB） between the two groups at the last follow?up （P < 0.05）. Conclusions In ACDF， the clinical efficacy of zero?profile interbody fusion cage and interbody fusion cage combined with titanium plate is similar， both of which can significantly improve cervical function and postoperative imaging indicators. However， the zero?profile interbody fusion cage significantly reduced the incidence of dysphagia compared with the interbody fusion cage combined with titanium plate. In the end?stage follow?up， the former is better than the latter in improving the Cobb angle of the fusion segment and ExGBB， which is more conducive to promoting bone graft fusion. Both fuses have the risk of sinking.