两种术式治疗多节段脊髓型颈椎病神经功能恢复的对比研究  

Study on recovery of nerve function in treatment of multilevel cervical spondylotic myelopathy with different surgical methods

作　　者：冯涛[1] 张宏[1] 任虎[1] 李熙明[1] 潘铄[1] 王晓静[1] 于大海[1] Tao Feng;Hong Zhang;Hu Ren;Xi-ming Li;Shuo Pan;Xiao-jing Wang;Da-hai Yu(The Fiest Department of Orthopedics,Shijiazhuang First Hospital,Shijiazhuang,Hebei 050011,China)

机构地区：[1]石家庄市第一医院骨科一病区,河北石家庄050011

出　　处：《中国现代医学杂志》2020年第13期56-61,共6页China Journal of Modern Medicine

基　　金：石家庄市科学技术局科学技术研究与发展计划项目(No:161460703)。

摘　　要：目的比较前路椎间隙减压植骨融合内固定术和后路单开门椎管扩大成形术治疗多节段脊髓型颈椎病的疗效。方法选取2015年1月-2017年12月石家庄市第一医院收治的多节段脊髓型颈椎病患者64例。按照随机数字表法将其分为观察组和对照组,每组32例。观察组由颈前路实施椎间隙减压植骨融合内固定术;对照组经后路实施单开门椎管扩大成形术。比较两组患者一般资料、手术情况、术后并发症情况、随访期间椎间高度、颈椎生理曲度C值等临床资料。结果观察组术中出血量、术后引流量要多于对照组,住院时间短于对照组(P<0.05)。术后1、3及6个月时观察组椎间高度、颈椎生理曲度C值及日本整形外科协会(JOA)评分高于对照组(P<0.05),视觉模拟评分(VAS)低于对照组(P<0.05)。结论对多节段脊髓型颈椎病,前路椎间隙减压植骨融合内固定术可较好地改善患者神经功能,保持颈椎曲度,减轻疼痛症状,效果优于经后路单开门椎管扩大成形术。Objective To compare the efficacy of posterior single-door laminoplasty with anterior intervertebral space decompression,bone grafting and internal fixation in the treatment of multilevel cervical spondylotic myelopathy.Methods From January 2015 to December 2017,64 patients with multilevel cervical spondylotic myelopathy admitted to our hospital were selected and divided into observation group and control group according to random number table method,32 cases in each group.In the observation group,anterior cervical intervertebral space decompression,bone grafting,fusion and internal fixation were performed,while in the control group,posterior single-door laminoplasty was performed.The clinical data was compared between two groups.Results The bleeding volume,drainage volume and hospitalization time in the observation group were less than those in the control group(P<0.05).At 1 month,3 months and 6 months after operation,the intervertebral height,C value of cervical vertebral physiological curvature and JOA score of the observation group were higher than those of the control group(P<0.05),and the VAS score was lower than that of the control group(P<0.05).Conclusion Compared with posterior single-door laminoplasty,anterior intervertebral space decompression,bone grafting,fusion and internal fixation can better improve the nerve function,maintain cervical curvature and relieve pain symptoms in the treatment of multi-level cervical spondylotic myelopathy,which conforms to the concept of minimally invasive,and is worth promoting.

关 键 词：脊髓型颈椎病 多节段 椎管扩大成形术 植骨融合内固定术 

分 类 号：R687.3[医药卫生—骨科学]