两种颈前路减压融合术治疗伴交感神经症状颈椎病的疗效分析  

Analysis of anterior cervical discectomy or corpectomy with fusion for treatment of 2-level cervical spondylosis accompanied by sympathetic symptoms

作　　者：孟阳[1] 张琰[1] 沈彬[1] 吴德升[1] 赵卫东[1] 黄宇峰[1] 张振[1] 于彬[1] 

机构地区：[1]同济大学附属东方医院脊柱外科,上海市200120

出　　处：《中国骨与关节损伤杂志》2013年第5期403-405,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较颈前路椎间盘切除减压融合术（ACDF）和颈前路椎体次全切除减压融合术（ACCF）治疗连续2节段伴交感神经症状颈椎病的疗效。方法自2001年1月-2011年8月收治连续2节段伴交感神经症状颈椎病48例。26例行ACDF术，22例行ACCF术，回顾性分析两组的临床及影像学资料。结果患者获随访16-58个月。两组间比较术后住院时间、JOA评分、交感神经症状评分、融合率及手术并发症比较，差异无统计学意义（P〉0．05）；手术时间、出血量、融合节段高度丢失及Cobb角丢失比较，ACCF组多于ACDF组，差异有统计学意义（P〈0．05）。结论采用ACDF和ACCF治疗连续2节段伴交感神经症状颈椎病均可取得满意的临床疗效；但ACDF较ACCF具有手术时间短、术中出血量少及更好地恢复和维持术后融合节段高度及前凸角度的优点。Objective To investigate clinical and radiologic results of anterior cervical discectomy with fusion （ACDF） and anterior cervical corpectomy with fusion （ACCF） in treatment of 2-level cervical spondylosis accompanied by sympathetic symptoms. Methods A total of 48 patients who underwent ACDF（n=26） or ACCF（n=22） for cervical spondylosis accompanied by sympathetic symptoms were eligible for this study in Jan. 2001 through Aug. 2011. The clinical and radiologic data of these 48 patients were retrospectively analyzed and compared between the two groups. Results All patients were followed up for 15-58 months. No significant difference was detected between the two groups on postoperative hospital stay, postoperative amelioration of JOA scores and sympathetic symptom scores, fusion rate and eomplication（P 〉0.05）. The operative time, blood loss, the height loss of fused segment and the Cobb＇s angle loss of fused segment were significantly greater in ACCF group（P 〈 0.05）. Conclusion ACDF and ACCF both obtained favorable clinical outcomes in treating 2-level cervical spondylosis accompanied by sympathetic symptoms. However, ACDF is superior over ACCF in terms of operation time and bleeding amount, segmental height and segmental Cobb＇s angle.

关 键 词：颈椎病 交感神经症状 椎间盘切除术 椎体次全切除术 融合 

分 类 号：R687.3[医药卫生—骨科学]