颈前路椎体次全切除术与椎间隙减压植骨融合术治疗邻近双节段颈椎病的临床疗效  

Clinical efficacy of anterior cervical fusion after corpectomy or discectomy in treatment of adjacent twolevel cervical spondylosis

作　　者：唐鹏宇 杨海源 罗勇骏 程琳 张宁 蔡卫华 殷国勇 

机构地区：[1]南京医科大学第一附属医院骨科,江苏省210029

出　　处：《江苏医药》2015年第16期1920-1922,共3页Jiangsu Medical Journal

摘　　要：目的比较颈前路椎体次全切除钛网植骨融合钛板内固定术(ACCF)与经双间隙减压椎间融合器植骨融合钛板内固定术(ACDF)治疗邻近双节段颈椎病的临床疗效。方法 46例邻近双节段颈椎病患者分为ACCF治疗组(A组,27例)和ACDF治疗组(B组,19例)。比较两组手术相关资料。结果 A组术中出血量、住院时间及内植物晚期沉降距离较B组增加(P<0.01或P<0.05)。与术前相比,两组术后日本骨科协会(JOA)评分提高(P<0.05),而颈椎生理曲度无明显变化(P>0.05)。与术后3d相比,A组术后3个月和末次随访时平均椎间高度降低(P<0.05)。两组间植骨融合率、JOA评分、颈椎生理曲度及平均椎间高度均无统计学差异(P>0.05)。结论 ACDF和ACCF治疗双节段颈椎病均取得满意的临床疗效;ACDF在术中出血量、住院时间及随访时内植物沉降距离方面优于ACCF。Objective To compare the clinical efficacy of a single‐level anterior cervical corpectomy and fusion（ACCF） and a two‐level anterior cervical diseectomy and fusion（ACDF） in the treatment of adjacent two‐level cervical spondylosis .Methods A total of 46 patients with two‐level cervical spondylosis was divided into two groups of A（operated by ACCF ,27 cases） and B（operated by ACDF ,19 cases） .The surgery‐related data were compared between two groups .Results The intraoperative blood loss ,hospital stay and distance of graft collapse were more in group A than those in group B（P〈0 .01 or P〈0 .05） .Compared with before ,JOA score was increased（P〈0 .05） ,while cervical physiological curvature was not significantly changed after operation in both groups （P〉0 .05） .The mean intervertebral height in the 3rd week after operation and at the time of final follow‐up was less than that on the 3rd day after operation in group A （P〈0 .05） .There were no statistical differences in JOA score ,cervical physiological curvature ,rate of bone fusion and mean intervertebral height between groups of A and B（P〉0 .05） .Conclusion Both ACDF and ACCF produce a satisfactory clinical efficacy in the treatment of two‐level cervical spondylosis .ACDF is superior to ACCF in reducing intraoperative blood loss ,hospital stay and graft collapse .

关 键 词：颈椎病 椎体次全切除术 椎间盘切除术 脊柱融合术 

分 类 号：R681[医药卫生—骨科学]