显微镜辅助颈椎前路减压内固定融合术在颈椎病治疗中的效果探究  

Effect of microscope-assisted anterior cervical decompression and fusion in treatment of cervical spondylosis

作　　者：孙鸣晓 王金财 SUN Ming-xiao;WANG Jin-cai(Department of Orthopedics,Yantai Yeda Hospital,Yantai,Shandong 264006,China;Imaging Department of Yantai Yeda Hospital,Yantai,Shandong 264006,China)

机构地区：[1]烟台业达医院骨一科,山东烟台264006 [2]烟台业达医院影像科,山东烟台264006

出　　处：《颈腰痛杂志》2024年第1期54-58,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探究显微镜辅助颈椎前路减压内固定融合术(anterior cervical decompression and fusion,ACDF)在颈椎病治疗中的效果。方法回顾性分析烟台业达医院2019年2月~2020年6月收治的78例颈椎病患者资料,按手术方式的不同分成A、B组。A组38例实施标准开放ACDF治疗,B组40例实施显微镜辅助ACDF。观察并记录两组手术参数,统计并发症发生情况,采用数字分级评分法(numerical rating scale,NRS)、日本骨科协会评分(Japanese orthopaedic association score,JOA)分别对两组术前、术后1年的疼痛度、颈椎神经功能进行评定,测量颈椎Cobb角,并计算颈椎神经功能改善率。结果B组手术用时、术中失血量均较A组少(P<0.05),术后住院时间组间比较无统计学差异(P>0.05);A组发生2例脑脊液漏,B组无并发症发生,组间比较无统计学差异(P>0.05);与同组术前相比,两组术后1年NRS、JOA评分、颈椎Cobb角均明显改善(P<0.05),而组间上述指标比较均无统计学差异(P>0.05);A组颈椎神经功能改善率89.47%与B组的92.50%相比,无统计学差异(P>0.05)。结论对颈椎病患者实施显微镜辅助ACDF的治疗效果较好,且具有手术用时短、术中失血量少等优势。Objective To explore the effect of microscope-assisted anterior cervical decompression and fusion(ACDF)on cervical spondylosis.Methods The data of 78 patients with cervical spondylosis admitted to Yantai Yeda Hospital from February 2019 to June 2020 were retrospectively analyzed,and they were divided into groups A and B according to different surgical methods.Thirty-eight patients in group A received standard open ACDF treatment,and 40 patients in group B received microscopy-assisted ACDF.The surgical parameters of the two groups were observed and recorded,the occurrence of complications was counted,and the pain degree and cervical nerve function of the two groups were evaluated before and one year after the operation,respectively by using the Numerical Rating Scale(NRS)and the Japanese Orthopaedic Association Scores(JOA),the cervical Cobb Angle were measured,and the improvement rate of cervical nerve function was calculated.Results The operation time and intraoperative blood loss of group B were shorter and less than those of group A(P<0.05),and there was no difference in the postoperative hospital stay between the groups(P>0.05);there were two cases of cerebrospinal fluid leakage in group A and no complications in group B,and there was no difference between the groups(P>0.05);the NRS,JOA scores and cervical Cobb angle of the two groups were significantly improved one year after operation compared with the same group before operation(P<0.05),but there was no difference in the above indicators between the groups(P>0.05);there was no difference in the improvement rate of cervical spine nerve function between group A(89.47%)and group B(92.50%)(P>0.05).Conclusion The treatment effect of microscope-assisted ACDF on cervical spondylosis patients is good,and it has advantages such as short surgical time and low intraoperative blood loss.

关 键 词：显微镜手术 颈椎前路减压内固定融合术 颈椎病 并发症 疼痛度 颈椎神经功能 

分 类 号：R653[医药卫生—外科学]