颈椎后路单开门与双开门椎管扩大成形术在多节段脊髓压迫症治疗中的效果分析  

Effect of Posterior Single and Double Door Opening Vertebral Canal Enlargement in the Treatment of Multilevel Spinal Cord Compression

作　　者：王海峰 WANG Haifeng(Department of Spinal Surgery,Jinan Eighth People's Hospital,Jinan,Shandong Province,271102 China)

机构地区：[1]济南市第八人民医院脊柱外科,山东济南271102

出　　处：《中外医疗》2024年第4期17-20,41,共5页China & Foreign Medical Treatment

摘　　要：目的探讨颈椎后路单开门与双开门椎管扩大成形术在多节段脊髓压迫症中的应用效果。方法方便选取2020年8月-2022年8月济南市第八人民医院收治的84例多节段脊髓压迫症患者作为研究对象,按随机数表法分为两组,各42例。对照组予以颈椎后路双开门椎管扩大成形术治疗,观察组予以颈椎后路单开门椎管扩大成形术治疗。比较两组患者的手术情况、颈椎功能、疼痛评分、生活质量及并发症。结果观察组的术中出血量为(281.41±20.38)mL,多于对照组的(246.34±18.74)mL,差异有统计学意义(t=8.209,P<0.05)。治疗后,观察组的颈椎病临床评价量表(Clinical Assessment Scale for Cervical Spondylosis,CASCS)评分中主观症状、临床体征、适应能力及总分均高于对照组,差异有统计学意义(t=5.579、6.000、10.830、6.962,P均<0.05);观察组术后7 d、术后3个月时视觉模拟评分法(Visual Analogue Scale,VAS)得分均低于对照组,差异有统计学意义(t=10.384、7.296,P均<0.05);观察组的生理、心理、社会及环境领域评分均高于对照组,差异有统计学意义(t=6.436、6.332、6.413、6.858,P均<0.05);两组患者的并发症对比,差异无统计学意义(χ^(2)=1.243,P=0.265)。结论颈椎后路单开门椎管成形术治疗多节段脊髓压迫症效果更佳,可减轻颈椎功能损伤,加快疼痛症状消失,改善生活质量,但其术中出血量较多,需依据具体情况合理选择术式。Objective To investigate the effect of posterior single and double door opening vertebral canal enlargement in the treatment of multilevel spinal cord compression.Methods A total of 84 patients with multilevel spinal cord compression treated in Jinan Eighth People's Hospital from August 2020 to August 2022 were conveniently selected and divided into two groups according to random number table method,with 42 patients in each group.The control group was treated with posterior cervical double door enlarged spinal canal enlargement,and the observation group was treated with posterior cervical single door enlarged spinal canal enlargement.The operative status,cervical function,pain score,quality of life and complications were compared between the two groups of patients.Results The intraop-erative blood loss in the observation group was(281.41±20.38)mL,which was higher than that in the control group(246.34±18.74)mL,and the difference was statistically significant(t=8.209,P<0.05).The subjective symptoms,clinical signs,adaptability and total scores of Clinical Assessment Scale for Cervical Spondylosis(CASCS)in the observa-tion group were higher than those in the control group after treatment,and the differences were statistically significant(t=5.579,6.000,10.830,6.962,all P<0.05).Visual Analogue Scale(VAS)scores in the observation group were lower than those in the control group at 7 days and 3 months after surgery,and the differences were statistically significant(t=10.384,7.296,both P<0.05).After treatment,the scores of physiological,psychological,social and environmental fields in the observation group were higher than those in the control group,and the differences were statistically significant(t=6.436,6.332,6.413,6.858,all P<0.05).There was no significant difference in complications between the two groups of patients(χ^(2)=1.243,P=0.265).Conclusion Posterior cervical single door spondyloplasty is more effective in the treatment of multilevel spinal cord compression,which can reduce cervical functional injury,acce

关 键 词：多节段脊髓压迫症 颈椎后路椎管扩大成形术 单开门 双开门 并发症 

分 类 号：R618.5[医药卫生—外科学]