不同手术方式治疗脊髓型颈椎病的临床效果  

Clinical efficacy of different operation methods in treating cervical spondylotic myelopathy

作　　者：刘伟峰[1] 高鑫 厉晓龙[1] 蒋文超 邵建树[1] 季旭彪 LIU Weifeng;GAO Xin;LI Xiaolong(Department of Orthopedics,Affiliated Wujin Hospital,Jiangsu University,Changzhou 213017,CHINA)

机构地区：[1]江苏大学附属武进医院脊柱外科,江苏常州213017

出　　处：《江苏医药》2018年第7期814-817,共4页Jiangsu Medical Journal

摘　　要：目的比较不同手术方式治疗脊髓型颈椎病的临床疗效。方法行颈椎前路椎间盘切除减压术的脊髓型颈椎病患者45例分为两组:A组,23例,采用自锁式固定嵌片融合器(ROI-C)植骨融合内固定术;B组,22例,采用颈椎前路钛板联合自体髂骨植骨融合内固定术。比较两组术后临床效果。结果 A组手术时间和术中出血量均少于B组[(78.2±11.9)min vs.(97.6±10.1)min和(43.7±18.5)ml vs.(85.8±20.5)ml](P<0.05)。A组吞咽不适发生率低于B组(0vs.13.6%)(P<0.05)。两组患者术后6个月及末次随访时的日本骨科学会评分高于术前(P<0.05)。45例患者ROI-C或自体髂骨融合均无移位,融合率达100%。结论与颈椎前路钛板联合自体髂骨植骨融合内固定术比较,采用ROI-C植骨融合内固定术治疗脊髓型颈椎病患者的临床效果较好,具有操作简便、创伤小、稳定性好和不良反应少等优势。Objective To compare the clinical efficacy of different operation methods in the treatment of cervical spondylotic myelopathy.Methods Forty-five patients with cervical spondylotic myelopathy underwent anterior decompression and fusion,who were randomly divided into two groups.The patients in group A（23 cases）were treated with self-locking fixation fusion cage（ROI-C）and those in group B（22 cases）were treated with autogenous iliac bone and titanium plate.The clinical outcomes were compared between two groups.Results Compared with group B,the operation time and intraoperative blood loss were less in group A [（78.2±11.9）min vs.（97.6±10.1）min and（43.7±18.5）ml vs.（85.8±20.5）ml]（P〈0.05）.The incidence of swallow discomfort in group A was lower than that in group B（0 vs.13.6%）（P〈0.05）.Japanese Orthopaedic Association scores in the 6 th month after operation and at the final follow-up were more than those before in both groups（P〈0.05）.No transposition of ROI-C or autogenous iliac bone occurred in 45 cases with the fusion rate of 100%.Conclusion For the treatment of cervical spondylotic myelopathy,the satisfactory clinical outcomes can be obtained by ROI-C internal fixation with the advantages of easier operation,smaller trauma,better stabilization and less adverse effect.

关 键 词：脊髓型颈椎病 颈椎前路减压融合术 自锁式固定嵌片融合器 自体髂骨 

分 类 号：R681[医药卫生—骨科学]