显微镜辅助颈前路减压植骨融合内固定术治疗颈椎病的效果分析  

Effectiveness of anterior cervical decompression and internal fixation for cervical diseases under microscope

作　　者：王洪伟[1] 段洪凯[1] 高飞[1] 孙连星[1] 赵湘军[1] 郭现辉[1] 刘晓强[1] 李铠湘 钟章华 谷昌伟 WANG Hong-wei;DUAN Hong-kai;GAO Fei;SUN Lian-xing;ZHAO Xiang-jun;GUO Xian-hui;LIU Xiao-qiang;LI Kai-xiang;ZHONG Zhang-hua;GU Chang-wei(Department of Spine Surgery,Dongguan Donghua Hospital,Dongguan,Guangdong 523110,China)

机构地区：[1]东莞东华医院骨科中心脊柱外科,广东东莞523110

出　　处：《中国骨与关节损伤杂志》2018年第7期676-678,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨显微镜辅助颈前路减压植骨融合内固定术治疗颈椎病的临床效果,并与标准开放颈前路减压植骨融合内固定术进行比较。方法纳入自2013-10—2016-06诊治的62例颈椎病,32例采用显微镜辅助颈前路减压植骨融合内固定术治疗(显微镜组),30例采用标准开放颈前路减压植骨融合内固定术治疗(开放组)。比较2组手术时间、术中出血量、末次随访时JOA评分,以及并发症情况。结果显微镜组未出现脊髓神经损伤,开放组1例出现硬膜损伤导致脑脊液漏,对症治疗后痊愈;2组并发症发生率差异无统计学意义(P>0.05)。显微镜组手术时间较开放组短,术中出血量较开放组少,差异有统计学意义(P<0.05)。62例均获得随访,随访时间平均24.5(18.5~24.8)个月。2组末次随访时JOA评分比较差异无统计学意义(P>0.05)。结论显微镜辅助颈前路减压植骨融合内固定术治疗颈椎病可取得与传统开放手术相同的疗效,术后患者脊髓神经功能均恢复良好;同时显微镜下手术具有创伤小、减压彻底、安全性高的优点。Objective To investigate the clinical efficacy of anterior cervical decompression and internal fixation for cervical diseases under microscope, and to compare with traditional method. Methods Sixty-two cases of cervical myelopathy from October 2013 to June 2016 were included. Thirty-two cases underwent anterior cervical decompression and internal fixation under microscope（microscope group） while thirty cases underwent traditional anterior cervical decompression and internal fixation operation（traditional group）. The operation time, intraoperative blood loss, postoperative complication, and JOA score of two groups were compared. Results Microscope group had no spinal cord and never root injury, 1 case showed spinal fluid leak in traditional group, recovered from symptomatic management. There was no significant difference in the complications between both groups after operation（P〉0.05）. The microscope group had significantly shorter operation time, less intraoperative blood loss than the traditional group（P〈0.05）. Sixty-two cases were followed up for 18.5 to 24.8 months（average of 24.5 months）. There was no significant difference in JOA score in last followed up（〉0.05）. Conclusion The good treatment outcomes were observed in anterior cervical decompression and internal fixation for cervical diseases under microscope compared with traditional operation. The recovery of spinal cord and never root function are good. The advantages is small injury, complete decompression and good safety of operation.

关 键 词：颈椎病 颈前路减压植骨融合内固定术 显微镜手术 

分 类 号：R681.5[医药卫生—骨科学]