颈前路椎间盘切除植骨融合术治疗双节段脊髓型颈椎病的疗效及并发症分析  

Analysis of efficacy and complications of anterior cervical discectomy and fusion in the treatment of double-segmental cervical spondylotic myelopathy

作　　者：曹况钟[1] 王勇平[1] 周永强[1] 陈晓 王林[1] CAO Kuang zhong;WANG Yong ping;ZHOU Yong qiang;CHEN Xiao;WANG Lin(Department of Orthopaedics,Neijiang First People's Hospital,Neijiang 641000,China)

机构地区：[1]四川省内江市第一人民医院骨科

出　　处：《实用医院临床杂志》2019年第6期150-153,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨颈前路椎间盘切除植骨融合术(ACDF)治疗双节段脊髓型颈椎病(CSM)的疗效及并发症。方法选取90例双节段CSM患者,其中48例行ACDF术治疗(观察组),42例行颈前路椎体次全切除植骨融合术(ACCF)治疗(对照组)。比较两组围术期指标、疗效及术后并发症发生率,观察手术前后影像学数据、临床评分变化情况。结果观察组手术时间长于对照组,术中出血量、术后引流量少于对照组(P<0.05);两组节段融合率均为100%,术后1、6月融合节段高度较术前增高(P<0.05),融合节段Cobb's角较术前增加,且观察组大于对照组(P<0.05);两组术后1、3、6月颈椎病日本骨科协会评估治疗分数(JOA)评分较术前升高,视觉模拟评分法(VAS)评分较术前降低(P<0.05)。结论ACDF和ACCF治疗双节段CSM均可取得较好疗效,有效改善颈椎功能和疼痛情况,且并发症发生较少,ACDF的优势在于手术创伤更小,更有利于维持颈椎生理弧度。Objective To explore the efficacy and complications of anterior cervical discectomy and fusion(ACDF)in the treatment of double segmental cervical spondylotic myelopathy(CSM).Methods Ninety patients with double segmental CSM were se lected.Of the patients,48 patients who underwent ACDF were set as observation group,and 42 patients who underwent anterior cervical corpectomy and fusion(ACCF)were included in control group.Perioperative indexes,efficacy and incidence rate of postoperative complications were compared between the two groups.Imaging data and clinical scores were observed before and after operation.Results The operative time in the observation group was longer than that in control group,and the intraoperative blood loss and postoperative drainage volume were less than those in control group(P<0.05).The segmental fusion rates in the two groups were both 100%,and the fusion segment height after 1 month and 6 months of operation was higher than that before operation(P<0.05),and the Cobb's angle of fusion segment was increased compared with that before operation.The angle in the observation group was larger than that in the control group(P<0.05).After 1 month,3 months and 6 months of operation,JOA score in the two groups was increased while the VAS score was decreased compared with that before operation(P<0.05).Conclusion Both ACDF and ACCF can achieve better efficacy in the treatment of double segmental CSM,and effectively improve the cervical function and pain and have few complications.ACDF has smaller surgical trauma,and it is more conducive to maintaining physiological radian of the cervical spine.

关 键 词：颈前路椎间盘切除 颈前路椎体次全切除 植骨融合术 脊髓型颈椎病 

分 类 号：R681.5[医药卫生—骨科学]