颈椎前路椎间盘切除融合术治疗多节段脊髓型颈椎病的临床研究  

Anterior cervical discectomy and fusion for the treatment of multi-segmental cervical spondylotic myelopathy

作　　者：陈绩[1] 江伟[1] 韩玉建 赵兵[2] CHEN Ji;JIANG Wei;HAN Yu-jian;ZHAO Bing(Department of Spine Surgery,Yibin Second People s Hospital,Yibin 644000,China;Department of Spine Surgery,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]四川省宜宾市第二人民医院脊柱外科,四川宜宾644000 [2]四川省绵阳市中心医院脊柱外科,四川绵阳621000

出　　处：《实用医院临床杂志》2018年第2期118-121,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨颈椎前路椎间盘切除融合术治疗多节段脊髓型颈椎病(CSM)的临床价值。方法选取我院收治的80例多节段CSM患者,按随机数字表法分为对照组与观察组各40例,对照组采用颈后路单开门椎板成形术治疗,观察组采用颈前路椎间盘切除植骨融合术治疗,记录两组围术期情况,统计手术并发症,观察治疗前后脊髓功能改善情况,测定手术前后疼痛程度及颈椎活动度的变化。结果观察组术中出血量、轴性疼痛发生率、术后不同时间颈椎功能障碍指数(NDI)评分低于对照组;Cobb角、颈椎曲度、颈椎总活动度(ROM)高于对照组(P<0.05)。结论在多节段CSM患者中采用颈前路椎间盘切除融合术对患者脊髓神经功能改善效果肯定,且手术并发症少,术后颈肩疼痛程度低,颈椎活动度改善明显。To investigate the clinical value of anterior cervical discectomy and fusion in the treatment of multi-segmental cervical spondylotic myelopathy(CSM).Eighty patients with multi-segmental CSM treated in our hospital from January 2013 to January 2017 were selected as study subjects.The patients were divided into control or observation group by using the random number table method,40 in each group.The control group was treated with posterior cervical open-door laminoplasty,while the observation group was treated with anterior cervical discectomy and bone graft fusion.The perioperative conditions of two groups were recorded,and complications were statistically analyzed.The improvement of spinal cord function before and after treatment was observed.The pain degree and changes of cervical spinal range of motion were determined before and after operation.The intraoperative bleeding volume,incidence of axial pain and scores of neck disability index(NDI)in the observation group was lower than those in the control group(P<0.05)while Cobb angles,cervical curvature and total cervical range of motion(ROM)of the observation group were larger or higher than those of the control group(P<0.05).The application of anterior cervical discectomy and fusion in the treatment of multi-segmental CSM can improve the spinal cord nerve function and complications are few.The postoperative pain degree is low and ROM can be improved significantly.

关 键 词：脊髓型颈椎病 多节段 颈前路椎间盘切除融合术 椎板成形术 

分 类 号：R681.5[医药卫生—骨科学]