两种联合手术治疗连续三节段颈椎病的疗效及术后吞咽困难并发症的比较分析  

Clinical results and comparison of postoperative dysphagia of two hybrid reconstructive techniques in contiguous 3-level cervical spondylosis

作　　者：阚利胜[1] 康健[1] 刘永[1] 陈雄生[1] 贾连顺[1] 

机构地区：[1]第二军医大学附属长征医院骨科,上海200003

出　　处：《脊柱外科杂志》2014年第2期65-69,共5页Journal of Spinal Surgery

摘　　要：目的 比较分析2种联合手术（hybrid surgery,HS）治疗连续3节段颈椎病的疗效及早期并发症.方法 回顾性分析2012年6月～2013年5月,因连续3个节段颈椎病行HS治疗的117例患者的临床资料.按手术方法分为短板（short plate,SP）组和长板（long plate,LP）组.比较分析2组日本骨科学会（Japanese Orthopaedic Association,JOA）评分及改善率、颈椎曲度、并发症等情况及一般资料.对比术前、术后1个月、术后3个月及末次随访时吞咽功能障碍简明量表（dysphagia short questionnaire,DSQ）评分,评估术后吞咽困难发生情况.结果 2组术后JOA评分均显著升高（P=0.00）,颈椎曲度明显改善（P=0.00）,并发症发生率未见明显差异（P＞0.05）.SP组在术后1个月、3个月时DSQ评分均显著低于LP组（P=0.01,P=0.00）.结论 2种HS治疗连续3节段颈椎病均可取得良好的近期疗效,并能较好的维持颈椎曲度;使用短颈椎前路钢板可能会降低术后吞咽困难的发生率.Objective To compare the clinical outcomes and early complications of 2 different hybrid surgeries （HS） in contiguous 3-level spondylosis.Methods A total of 117 consecutive patients with contiguous 3-level cervical spondylosis treated by 2 HS were retrospectively reviewed.The patients were divided into 2 groups：short plate （SP） group and long plate （LP） group.The Japanese Orthopaedic Association （JOA） score,JOA score improvement rate,cervical curvature and the incidence of complications were compared during the follow-up.The postoperative dysphagia was also analyzed using a dysphagia short questionnaire （DSQ）.Results In both of the 2 groups,the JOA scores and the cervical curvature significantly improved after operations （P =0.00）,and no significant difference was found in terms of the incidence of complications （P 〉0.05）.The scores of DSQ in the SP group were significantly lower than that in the LP group （P =0.01,P =0.00）.Conclusion Both of the 2 HS have favorable clinical results in the treatment of contiguous 3-level cervical spondylosis.Moreover,the hybrid reconstructive technique using a short plate may have the ability of decreasing the likelihood of postoperative dysphagia in appropriate patients.

关 键 词：颈椎 手术后并发症 外科手术 

分 类 号：R681.531[医药卫生—骨科学]