脊髓型颈椎病前路减压融合术的预后因素分析  

Analysis of predictive factors after anterior cervical decompression and fusion for cervical spondylotic myelopathy

作　　者：邱闯[1] 贺明[1] 王广斌[1] 王佳时[1] 白伦浩[1] 

机构地区：[1]中国医科大学附属盛京医院第四骨科病房,辽宁沈阳110000

出　　处：《中国医药导报》2015年第27期89-92,共4页China Medical Herald

摘　　要：目的 分析脊髓型颈椎病患者前路间盘切除减压植骨融合术的预后因素。方法 收集2000年12月~2003年8月中国医科大学附属盛京医院87例行颈椎前路间盘切除减压植骨融合术的脊髓型颈椎病患者,按照颈椎病脊髓功能改善情况分为改善率≥75%组和改善率〈75%组,利用单因素分析和多因素分析方法 评价年龄、性别、职业、教育程度、吸烟史、术前肢体疼痛强度及频率、病程、DRAM评分、JOA评分、止痛药使用情况等因素与颈椎病预后的关系。结果单因素分析发现年龄、吸烟史、术前肢体疼痛强度、病程、DRAM评分、JOA评分与疾病的预后有关（P〈0.05）,多元线性回归分析发现吸烟史,颈痛、上肢痛,JOA评分与治疗结局密切相关。结论无吸烟嗜好、术前JOA评分较高以及颈痛和上肢痛强度低均提示较好的预后,但需重视DRAM评分对脊髓型颈椎病减压手术预后的影响。Objective To detect the factors that affect the prognosis of anterior cervical decompression and fusion for cervical spondylotic myelopathy. Methods From December 2000 to August 2003, in Shengjing Hospital of China Medical University, 87 patients with cervical spondylotic myelopathy after anterior cervical decompression and fusion operation were collected and divided into improvement rate ≥ 75% group and improvement rate 〈 75% group, according to the function improvement of the cervical spinal cord disease, using of monofactorial analysis and multiple linear regression, the association between prognosis and age, sex, occupation, educational level, smoking, strength and frequency of preoperative limb pain, course of disease, DRAM score, JOA score, use of analgetica and so on were analyzed. Results Monofactorial analysis showed that age, smoking, strength of preoperational limb pain, course of disease, DRAM score and JOA score related to prognosis （P 〈 0.G5）. Multiple linear regression suggested that smoking, strength of preopera- tive limb pain and JOA score had significant correlation with the prognosis. Conclusion Non-smoking, lower preoperative pain level of neck and upper limb, and higher JOA scores predict better prognosis, the contribution of DRAM score to the prognosis of cervical spondylotic myelopathy should not be ignored at the same time.

关 键 词：脊髓型颈椎病 前路减压融合术 颈椎间盘切除 自体髂骨植骨 钛板内固定 

分 类 号：R687.3[医药卫生—骨科学]