影像学异常的交感神经型颈椎病26例手术疗效分析  

Evaluation of surgical outcomes of sympathetic cervical spondylosis with abnormal imaging

作　　者：朱忠培[1] 宋瑞鹏[1] 张敏[1] 吴研飞 张扬 马丽萍[2] 朱一鹏 王卫东[1] 张书豪[1] 廖文胜 王利民[1] Zhu Zhongpei;Song Ruipeng;Zhang Min;Wu Yanfei;Zhang Yang;Ma Liping;Zhu Yipeng;Wang Weidong;Zhang Shuhao;Liao Wensheng;Wang Limin(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Laboratory of Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Spine and Spinal Cord Surgery,Henan Provincial People′s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院骨外科,450000 [2]郑州大学第一附属医院外总实验室,450000 [3]河南省人民医院脊柱脊髓外科,450000

出　　处：《中华实验外科杂志》2021年第7期1370-1372,共3页Chinese Journal of Experimental Surgery

摘　　要：目的:探讨存在影像学异常的交感神经型颈椎病(SCS)开放手术的治疗效果。方法:总结2015年至2018年郑州大学第一附属医院应用颈前路椎间盘摘除植骨融合内固定术治疗的影像学异常的交感神经型颈椎病患者26例;根据躯体化症状自评量表和交感神经症状20分评分法对患者手术前后1周及末次随访进行评分。结果:26例患者术前SSS评分(45.50±10.39)分,术后1周评分(27.67±3.62)分,末次随访21.50(11)分,其中术后1周、末次随访与术前SSS评分比较分别降低17.83分[95%可信区间(CI):4.660~31.007,P<0.05]、18.00分(95%CI:-0.701~36.701,P>0.05),末次随访与术后1周SSS评分无统计学差异(95%CI:-17.840~18.174,P>0.05)。术前交感神经症状20分评分法评分(8.50±1.87)分,术后1周评分1(2)分,末次随访评分0.5(4)分,其中术后1周、末次随访与术前20分评分比较分别降低6.67分(95%CI:3.980~9.353,P<0.05)、6.17分(95%CI:0.660~11.673,P<0.05),末次随访与术后1周20分评分无统计学差异(95%CI:-4.879~5.879,P>0.05)。末次随访1例患者出现部分症状复发,其余25例患者获得明显改善,无复发症状。结论:对于存在影像学异常的SCS,ACDF可以取得良好的治疗效果。Objective To evaluate the outcome of surgery for sympathetic cervical spondylosis with abnormal imaging.Methods The patients with sympathetic cervical spondylosis with the abnormal imaging who received anterior cervical discectomy and fusion(ACDF)treatment from 2015-2018 were reviewed.The symptoms wee scored with somatization self-rating scale(SSS)and 20 points evaluation system before and after operation and at the last follow-up.Results The SSS scores before,after the operation and at the last follow-up were(45.50±10.39),(27.67±3.62)and 21.50(11)respectively.The scores at postoperative week one and last follow-up were 17.83(95%CI:4.660-31.007,P<0.05)and 18.00(95%CI:-0.701-36.701,P>0.05)respectively,which were lower than preoperative scores.There was no significant difference in SSS scores between the last follow-up and postoperative week one(95%CI:-17.840-18.174,P>0.05).The scores by the 20 points evaluation system were(8.50±1.87)before the operation,1(2)at first week after operation,and 0.5(4)at the last follow-up.As compared with preoperative scores,the scores at postoperative week 1 and last follow-up decreased by 6.67(95%CI:3.980-9.353,P<0.05)and 6.17(95%CI:0.660-11.673,P<0.05)respectively.There was no significant difference between the last follow-up and one week after operation(95%CI:-4.879-5.879,P>0.05).At the last follow-up,one patient showed part of the recurrence symptoms,and the rest 25 patients recovered without relapse.Conclusion ACDF can achieve good therapeutic effect for sympathetic cervical spondylosis with abnormal imaging.

关 键 词：交感神经型颈椎病 颈椎间盘摘除术 躯体化症状 

分 类 号：R687.3[医药卫生—骨科学]