颈椎前后路联合手术治疗多节段脊髓型颈椎病的效果研究  

Effect of anterior and posterior cervical approach combined with surgery for the treatment of multilevel cervical spondylotic myelopathy

作　　者：王飞 Wang fei(nanchong gaoping district people's hospital,nanchong sichuan 637000)

机构地区：[1]南充市高坪区人民医院,四川南充637000

出　　处：《当代医药论丛》2020年第3期53-54,共2页

摘　　要：目的:探讨用颈椎前后路联合手术治疗多节段脊髓型颈椎病的临床效果。方法:选取南充市高坪区人民医院在2013年7月至2015年6月收治的96例多节段脊髓型颈椎病患者作为研究对象。将其随机分为后路手术组和前后路联合手术组(48例/组)。为后路手术组患者采用颈椎后路单开门椎管成形术进行治疗,为前后路联合手术组患者采用颈椎前后路联合手术进行治疗。然后对比两组患者的治疗效果。结果:1)在术前,两组患者的JOA评分相比,差异不具有统计学意义(P>0.05)。在术后,两组患者的JOA评分均较术前明显提高,且前后路联合手术组患者的JOA评分高于后路手术组患者,差异具有统计学意义(P<0.05)。在术后,前后路联合手术组患者JOA评分的改善率高于后路手术组患者,差异具有统计学意义(P<0.05)。2)在术前,两组患者硬脊膜囊的矢状径相比,差异不具有统计学意义(P>0.05)。在术后,两组患者硬脊膜囊的矢状径均较术前明显增大,且前后路联合手术组患者硬脊膜囊的矢状径大于后路手术组患者,差异具有统计学意义(P<0.05)。在术后,前后路联合手术组患者硬脊膜囊形态的改善率高于后路手术组患者,差异具有统计学意义(P<0.05)。结论:对多节段脊髓型颈椎病患者采用颈椎前后路联合手术进行治疗的效果显著,可有效地解除其脊神经遭受的压迫,改善其神经功能。objective:to investigate the clinical effect of anterior and posterior cervical approach combined with surgery in the treatment of multilevel cervical spondylotic myelopathy.Methods:a total of 96 patients with cervical spondylotic myelopathy who were admitted to gaoping district people's hospital of nanchong city from July 2013 to June 2015 were selected as the study subjects.They were randomly divided into the posterior surgery group and the combined anterior and posterior surgery group(48 cases/group).Patients in the posterior surgery group were treated with cervical vertebra posterior single-door open laminoplasty,and patients in the anterior and posterior combined surgery group were treated with anterior and posterior combined surgery.The two groups were then compared.Results:1)there was no statistically significant difference in preoperative JOA score between the two groups(P>0.05).After the operation,the JOA score of the two groups was significantly improved compared with that before the operation,and the JOA score of the patients in the anterior and posterior combined surgery group was higher than that of the patients in the posterior surgery group,the difference was statistically significant(P<0.05).After the operation,the improvement rate of JOA score in the anterior and posterior combined surgery group was higher than that in the posterior surgery group,and the difference was statistically significant(P<0.05).2)before surgery,there was no statistically significant difference in the sagittal diameter of the dural sac between the two groups(P>0.05).After surgery,the sagittal diameter of the dural sac in the two groups increased significantly compared with that before surgery,and the sagittal diameter of the dural sac in the anterior and posterior combined surgery group was larger than that in the posterior surgery group,with statistically significant differences(P<0.05).After surgery,the improvement rate of dural sac morphology in the anterior and posterior combined surgery group was higher than that in t

关 键 词：颈椎前后路联合手术 多节段脊髓型颈椎病 神经功能 硬脊膜囊的矢状径 

分 类 号：R681.5[医药卫生—骨科学]