3D显微镜辅助下颈椎前路间盘切除椎体间植骨融合术的临床疗效  

Clinical effect of anterior cervical surgery assisted by 3D microscope.

作　　者：王鹏涛 张嘉男[2] 刘团江[2] 刘鹏[2] 贺宝荣[2] 郝定均[2] WANG Peng-tao;ZHANG Jia-nan;LIU Tuan-jiang;LIU Peng;HE Bao-rong;HAO Ding-jun(Xi'an Medical University,Xi'an 710021,China;Department of Spinal Surgery,Honghui Hospital Affiliated to Medical College of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安医学院,西安710021 [2]西安交通大学医学院附属红会医院脊柱外科,西安710054

出　　处：《骨科》2021年第3期232-235,253,共5页ORTHOPAEDICS

基　　金：国家自然科学基金重点项目(81830077)。

摘　　要：目的探讨3D显微镜辅助下颈椎前路间盘切除椎体间植骨融合术(anterior cervical discet⁃omy and fusion,ACDF)的临床疗效。方法回顾性研究2018年12月至2020年1月在我院行ACDF手术的病人178例。其中,2018年12月至2019年7月行传统ACDF手术的103例纳入常规组,2019年8月至2020年1月行3D显微镜辅助下ACDF手术的75例纳入3D显微镜组。收集并对比两组病人的手术时间、术中出血量、手术相关并发症以及手术前后的疼痛视觉模拟量表(visual analogue scale,VAS)评分及日本骨科协会(Japanese Orthopaedic Association,JOA)评估治疗分数。结果两组病人均未发生严重的神经损伤和血管损伤。常规组发生脑脊液漏1例,喉返神经麻痹1例,喉上神经麻痹1例;3D显微镜组未发现手术相关并发症。3D显微镜组的手术时间和出血量分别为(171.72±64.82)min、(57.19±26.38)mL,明显少于常规组的(195.39±67.31)min、(66.54±23.27)mL,组间比较,差异均有统计学意义(P均<0.05)。末次随访两组病人间的JOA评分及VAS评分比较,差异均无统计学意义(P均>0.05)。结论3D显微镜辅助下颈前路手术安全有效,可为术者提供立体的视图效果,与传统手术方式相比,手术时间及术中出血量更少。Objective To investigate the clinical effect of anterior cervical discectomy and fusion(ACDF)assisted by 3D microscope.Methods A retrospective study was conducted on 178 patients who underwent ACDF in our hospital from December 2018 to January 2020.Among them,103 patients who underwent traditional ACDF from December 2018 to July 2019 were included in the conventional group,and 75 patients who underwent 3D microscope assisted ACDF from August 2019 to January 2020 were included in the 3D microscope group.The operation time,intraoperative blood loss,operation related complications,visual analogue scale(VAS)score and Japanese Orthopaedic Association(JOA)score were collected and compared between the two groups.Results There was no serious nerve injury and vascular injury in both groups.In the conventional group,there was 1 case of cerebrospinal fluid leakage,1 case of recurrent laryngeal nerve palsy and 1 case of superior laryngeal nerve palsy.No operation related complications were found in the 3D microscope group.The operation time and blood loss in the 3D microscope group were(171.72±64.82)min and(57.19±26.38)mL respectively,which were significantly reduced as compared with(195.39±67.31)min and(66.54±23.27)mL respectively in the conventional group(all P<0.05).There was no significant difference in JOA score and VAS score between the two groups at the last follow⁃up(all P>0.05).Conclusion The 3D microscope assisted anterior cervical surgery is safe and effective,which can provide three⁃dimensional view for the operator.It has less operation time and intraoperative blood loss than the conventional surgery.

关 键 词：脊髓型颈椎病 颈前路 传统术式 3D显微镜辅助 临床效果 

分 类 号：R687.3[医药卫生—骨科学]