多节段脊髓型颈椎病两种手术方式的疗效比较  

Outcomes comparison of two types of approachs for the treatment of multilevel cervical spondylotic myelopathy

作　　者：江帅[1] 卜海富[1] 隋聪[1] 刘德宝[1] 张复文[1] 

机构地区：[1]安徽医科大学第一附属医院骨科一病区,安徽合肥230022

出　　处：《临床骨科杂志》2015年第1期18-22,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较后路单开门椎板成形术与前后路联合手术治疗多节段脊髓型颈椎病的临床疗效。方法 40例多节段脊髓型颈椎病患者,20例行颈椎后路单开门椎管成形术（单纯后路组）,20例行前后路联合手术（前后路联合组）,比较两组手术时间、术中出血量、JOA评分、手术并发症,评价两种手术方式的临床疗效。结果患者均获得随访,时间6～30个月。手术时间：单纯后路组（100±30）min,前后路联合组（180±20）min,两组比较差异有统计学意义（P〈0.05）。术中出血量：单纯后路组（200±50）ml,前后路联合组（300±60）ml,两组比较差异有统计学意义（P〈0.05）。JOA评分：单纯后路组术前（8.52±2.42）分,术后（14.12±2.33）分,P〈0.05;前后路联合组术前（8.66±2.50）分,术后（14.20±2.60）分,P〈0.05;两组间疗效比较差异无统计学意义（P〉0.05）。结论后路单开门椎板成形术和前后路联合手术治疗多节段脊髓颈椎病神经功能改善相似,但前者手术时间短、出血量少。Objective To compare the clinical outcomes between posterior approach and combined anterior-posterior procedures for the treatment of multilevel cervical spondylotic myelopathy. Methods The preoperative and postoperative data of 40 patients with multilevel cervical spondylotic myelopathy were reviewed. 20 patients were used posterior procedure（ Posterior group） and 20 combined anterior-posterior procedure（ Combined anterior-posterior group）.The clinical outcomes were analyzed by blood loss,operation time,JOA score and complication rate. Results The followed-up time ranged from 6 to 30 months. In the posterior group,the operation time was（ 100 ± 30） min,blood loss was（ 200 ± 50） ml,JOA scores was（ 8. 52 ± 2. 42） before operation and（ 14. 12 ± 2. 33） after operation. While in the combined anterior-posterior group,the operation time was（ 180 ± 20） min,blood loss was（ 300 ± 60） ml,JOA scores was（ 8. 66 ± 2. 50） before operation and（ 14. 20 ± 2. 60） after operation. The blood loss and operation time were significant higher in the combined anterior-postoperative group compared with the posterior group（ P〈0. 05）.JOA scores of all patients were improved by different degrees after operations. Posterior and combined anterior-posterior methods both achieved higher mean improvement rates,there were no significant differences in the two groups（ P〉0. 05）. Conclusions Posterior approach and combined anterior-posterior procedures have the same effect for the neurological function recovery in the treatment of multilevel cervical spondylotic myelopathy,however,posterior procedure are lower in blood loss and operation time.

关 键 词：多节段脊髓型颈椎病 后路单开门椎板成形术 前后路联合手术 

分 类 号：R687.3[医药卫生—骨科学] R681.53[医药卫生—外科学]