两种术式治疗多节段脊髓型颈椎病的对比分析  

Comparative Analysis of LMP and ACDF in the Treatment of Multilevel Cervical Spondylotic Myelopathy

作　　者：张若银 ZHANG Ruoyin(Department of Spine Surgery,Feicheng Hospital,Shandong Guoxin Yiyang Group,Feicheng Shandong 271608,China)

机构地区：[1]山东国欣颐养集团肥城医院脊柱外科,山东肥城271608

出　　处：《中国卫生标准管理》2021年第13期75-79,共5页China Health Standard Management

摘　　要：目的比较后路椎管扩大成形术(laminoplasty,LMP)与颈椎前路减压分段融合术(anterior cervical discectomyand fusion,ACDF)治疗多节段脊髓型颈椎病(cervical spondylotic myelopathy,CSM)的效果。方法90例研究对象均为2018年10月—2020年9月医院收治的多节段CSM患者,以随机数字表法划分为两组。对照组45例实施LMP治疗,研究组45例实施ACDF治疗。比较两组手术时间、术中失血量、住院时间,术前与术后3个月时日本骨科协会评估治疗分数(Japanese orthopaedic association scores,JOA)、术前与术后颈椎生理曲度C值与病变节段椎间高度,以及术后并发症情况。结果研究组手术时间、术中失血量、住院时间较对照组更低(P<0.01)。术后研究组JOA评分与对照组对比差异无统计学意义(P>0.05)。术后研究组颈椎生理曲度C值、病变节段椎间高度较对照组更高(P<0.01)。在术后并发症发生率比较中,研究组与对照组比较差异无统计学意义(P>0.05)。结论LMP与ACDF治疗多节段CSM的效果相当,但ACDF具有操作简便、出血少、利于患者康复等优势,且改善了颈椎曲度与椎间高度。Objective To compare the effects of posterior laminoplasty(LMP)and anterior cervical decompression and fusion(ACDF)in the treatment of multilevel cervical spondylotic myelopathy(CSM).Methods 90 patients with multi segment CSM in our hospital from October 2018 to September 2020 were randomly divided into two groups.45 cases in the control group were treated with LMP,and 45 cases in the study group were treated with ACDF.The operation time,intraoperative blood loss,length of hospital stay were compared between the two groups,and the Japanese orthopaedic association scores(JOA)before and 3 months after the operation,and the C value of cervical spine physiological curvature before and after the operation,intervertebral height of the diseased segment and postoperative complications were compared.Results The operation time,intraoperative blood loss and hospitalization time of the study group were lower than those of the control group(P<0.01).There was no significant difference in JOA score between the study group and the control group(P>0.05).The C value of cervical lordosis in the study group,and the intervertebral height of the diseased segment,which was higher than the control group(P<0.01).There was no significant difference in the incidence of postoperative complications between the study group and the control group(P>0.05).Conclusion The effect of LMP and ACDF in the treatment of multi segment CSM is similar,but ACDF has the advantages of simple operation,less bleeding,conducive to the rehabilitation of patients,and improves the cervical curvature and intervertebral height.

关 键 词：后路椎管扩大成形术 颈椎前路减压分段融合术 多节段 脊髓型颈椎病 颈椎生理曲度 椎间高度 

分 类 号：R681[医药卫生—骨科学]