脊柱内镜下半椎板切除术与ACDF治疗颈椎管狭窄症的对比分析  

Comparison of outcomes between spinal endoscopic hemi-laminectomy and ACDF for patients with cervical spinal stenosis

作　　者：王国壮 张雷鸣 张剑宁 康建刚 穆俊康 任斌 白茫茫[1] WANG Guo-zhuang;ZHANG Li-ming;ZHANG Jian-ning;KANG Jian-gang;MU Jun-kang;REN Bin;BAI Mang-mang(Department of Neurosurgery,Affiliated Hospital of Yan'an University,Shaanxi 716000,China;Department of Neurosurgery,The First Medical Center of PLA General Hospital,Beijing 100048,China;Department of Traditional Chinese Medicine,The First Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]延安大学附属医院神经外科,陕西延安716000 [2]中国人民解放军总医院第一医学中心神经外科医学部,北京100048 [3]中国人民解放军总医院第一医学中心中医医学部,北京100048

出　　处：《中国临床神经外科杂志》2021年第5期343-345,348,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的对比分析脊柱内镜下半椎板切除术和颈椎前路椎间盘切除融合术(ACDF)治疗颈椎管狭窄症(CSS)的疗效。方法回顾性分析2015年1月至2019年12月手术治疗的50例单节段或双节段CSS的临床资料。26例行ACDF(ACDF组),24例行脊柱内镜下半椎板切除术(内镜组)。50例术后随访6~62个月,其中内镜组平均随访(24.4±16.4)个月,ACDF组平均随访(25.7±18.0)个月。结果内镜组手术时间、术中出血量与住院时间较ACDF组均明显减少(P<0.05)。两组末次随访日本骨科协会(JOA)评分、颈椎功能障碍指数量表评分及视觉模拟量表评分较术前均明显改善(P<0.05),但两组之间均无明显差异(P>0.05)。两组JOA评分改善率、临床疗效均无统计学差异(P>0.05)。结论脊柱内镜下半椎板切除术和ACDF治疗CSS的疗效相当,但脊柱内镜下半椎板切除术具有创伤小、风险低、恢复快等优点。Objective To compare the clinical effect of endoscopic hemi-lamiectomy(EHL)and anterior cervical discectomy and fusion(ACDF)on the patients with cervical spinal stenosis(CSS).Methods The clinical data of 50 patients with CSS,of whom 26 patients received ACDF(ACDF group)and 24 received EHL(EHL group)from January 2015 to December 2019,were analyzed retrospectively.The follow-up of these 50 patients ranged from 6 months to 62 months.The average follow-up time was(24.4±16.4)months in EHL group and(25.7±18.0)in ACDF group.Results The operation time,intraoperative blood loss and hospital stay in the EHL group significantly reduced compared with the ACDF group(P<0.05).The scores of Japanese Orthopaedic Association(JOA)scale,neck disabilitv index scale and visual analogue scale significantly decreased in both groups at last follow-up than those before the operation(P<0.05),but there was no statistically significant difference between the two groups at last follow-up(P>0.05).There was no statistically significant difference in the improvement rate of JOA score and clinical effectiveness between the two groups at last followup(P<0.05).Conclusions EHL and ACDF have the similar curative effect on the patients with CSS,but EHL has the advantages of less trauma,low risk,and quick recovery.

关 键 词：颈椎管狭窄症 脊髓型颈椎病 脊柱内镜 半椎板切除术 颈椎前路椎间盘切除融合术(ACDF) 

分 类 号：R681.55[医药卫生—骨科学] R651.11[医药卫生—外科学]