颈椎前路椎间盘切除融合术治疗多节段脊髓型颈椎病的临床疗效  

Clinical efficacy of anterior cervical discectomy and fusion for multilevel cervical spondylotic myelopathy

作　　者：王国旗 刘羽[1] 王红辉[1] 李鹏[1] 王腾飞 张学登 WANG Guo-qi;LIU Yu;WANG Hong-hui;LI Peng;WANG Teng-fei;ZHANG Xue-deng(The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000 China)

机构地区：[1]南阳医学高等专科学校第一附属医院,河南南阳473000

出　　处：《医药论坛杂志》2022年第2期39-43,共5页Journal of Medical Forum

摘　　要：目的探讨颈椎前路椎间盘切除融合术治疗多节段脊髓型颈椎病的临床疗效。方法 2015年1月—2019年12月南阳医学高等专科学校第一附属医院90例多节段脊髓型颈椎病患者,符合纳入、排除标准88例,根据手术方式分为对照组(颈椎后路椎管成形术,n=43)、研究组(颈椎前路椎间盘切除融合术,n=45)。比较两组手术时间、术中出血量、住院时间,观察随访期间颈椎功能障碍指数(NDI)、关节活动度(ROM),统计日本骨科协会(JOA)评分改善率、术后并发症发生率。结果与对照组比较,研究组术中出血量减少,住院时间缩短(P<0.05);与对照组比较,研究组术后3、6、12个月时颈椎ROM升高,NDI指数降低(P<0.05);研究组JOA改善优良率为77.78%,对照组为72.09%(P>0.05);研究组总体并发症发生率为4.44%,低于对照组20.93%(P<0.05)。结论多节段脊髓型颈椎病采用颈椎前路椎间盘切除融合术治疗效果理想,可改善颈椎ROM、NDI指数,减少并发症发生。Objective To investigate the clinical effect of anterior cervical discectomy and fusion in the treatment of multi segmental cervical spondylotic myelopathy.Method From January 2015 to December 2019,90 patients with multi segmental cervical spondylotic myelopathy in our hospital,88 patients met the inclusion and exclusion criteria,were divided into control group(posterior cervical laminoplasty,n=43) and study group(anterior cervical discectomy and fusion,n=45).The operation time,intraoperative blood loss and hospital stay were compared between the two groups.Cervical neck Disability Index(NDI) and range motion(ROM) index were observed during the follow-up period.The improvement rate of JOA score and the incidence of postoperative complications were calculated.Results Compared with the control group,the intraoperative blood loss and hospitalization time of the study group were reduced(P<0.05).Compared with the control group,the ROM of cervical spine increased and NDI index decreased in the study group at 3 months,6 months and 12 months after operation(P<0.05).The excellent and good rate of JOA improvement was 77.78% in the study group and 72.09% in the control group(P>0.05).The overall incidence of complications in the study group was 4.44%,which was lower than 20.93% in the control group(P<0.05).Conclusion The effect of anterior cervical discectomy and fusion treatment on multilevel cervical spondylotic myelopathy is ideal,it can improve cervical ROM and NDI index and reduce complications.

关 键 词：多节段脊髓型颈椎病 颈椎前路椎间盘切除融合术 疗效 颈椎功能障碍指数 关节活动度 

分 类 号：R581.5[医药卫生—内分泌]