显微镜辅助下颈椎前路椎间盘切除融合术治疗脊髓型颈椎病  

Treatment of cervical spondylotic myelopathy with microscopy assisted anterior cervical discetomy and fusion

作　　者：袁龙华 陈栋 王锦付 刘金学 YUAN Long-hua;CHEN Dong;WANG Jin-fu;LIU Jin-xue(Dept of Spinal Surgery,Sihong Fenjinting Hospital,Suqian,Jiangsu 223009,China)

机构地区：[1]泗洪分金亭医院脊柱外科,江苏宿迁223009

出　　处：《临床骨科杂志》2024年第5期613-616,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨显微镜辅助下颈椎前路椎间盘切除融合术(ACDF)治疗脊髓型颈椎病的疗效。方法采用显微镜辅助下ACDF治疗24例脊髓型颈椎病患者。记录手术时间、术中出血量、术后并发症发生情况。采用JOA评分评价脊髓功能改善情况。结果患者均获得随访,时间6~24个月。手术时间45~110 min,术中出血量15~45 ml。术后均无切口感染、神经损伤、脑脊液漏等并发症发生。JOA评分术后各时间点均大于术前(P<0.01),且随时间延长评分越来越高(P<0.05)。末次随访时椎间均骨性融合,采用JOA评分评价的脊髓功能改善优良率为21/24。结论显微镜辅助下ACDF治疗脊髓型颈椎病具有术中出血量少、并发症少、减压彻底、脊髓功能改善明显的优点。Objective To investigate the effect of microscopy assisted anteriorcervical discectomy and fusion(ACDF)in the treatment of cervical spondylotic myelopathy.Methods Twenty-fourpatients with cervical spondylotic myelopathy were treated with microscopy assisted ACDF.Operation time,intraoperative blood loss and postoperative complications were recorded.The improvement of spinal cord function was evaluated by JOA score.Results All patients were followed up for 6~24 months.The surgical time was 45~110 min,and the intraoperative bleeding volume was 15~45 ml.There were no postoperative complications such as incision infection,nerve injury orcerebrospinal fluid leakage.The JOA score was higherat all time points aftersurgery than before surgery(P<0.01),and the scores got higherand higherovertime(P<0.05).At the last follow-up,the bony fusion was obtained in the intervertebral space,the excellent-good rate of spinal cord function improvement evaluated by JOA score was 21/24.Conclusions Microscopy assisted ACDF in the treatment of cervical spondylotic myelopathy has the advantages of less bleeding volume,fewercomplications,compete decompression and obvious improvement of spinal cord function.

关 键 词：显微镜辅助 颈椎前路椎间盘切除融合术 脊髓型颈椎病 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]