ACDF与ACCF治疗双节段颈椎病的效果对比分析  

Comparative Analysis of the Effect of ACDF and ACCF in Double-segment Cervical Spondylosis

作　　者：徐东阳 吴杰 管礼安 薛书生 XU Dongyang;WU Jie;GUAN Li’an;XUE Shusheng(Department of Spinal Division 2,Huai’an 82 Hospital,Huai’an 223001,China;不详)

机构地区：[1]淮安八十二医院脊柱二科,江苏淮安223001

出　　处：《中国医学创新》2024年第28期153-157,共5页Medical Innovation of China

摘　　要：目的:分析并比较颈椎前路椎间盘切除减压融合术(anterior cervical discectomy and fusion,ACDF)、颈椎前路椎体次全切除减压融合术(anterior cervical corpectomy and fusion,ACCF)在双节段颈椎病的应用效果。方法:选择2020年12月—2023年12月淮安八十二医院接收的90例双节段颈椎病患者,利用最新统计学软件生成随机序列后分为对照组、观察组,各45例。对照组予以ACCF治疗,观察组予以ACDF治疗。对比两组围手术期指标、疼痛缓解情况、颈椎功能恢复情况及不良事件发生情况。结果:观察组围手术期指标(手术时间、术中出血量、术后引流量、下床时间及住院时间)均优于对照组,差异均有统计学意义(P<0.05)。治疗前、治疗后14 d及1、2个月,两组数字评分法(numeric rating scales,NRS)评分比较,差异均无统计学意义(P>0.05)。治疗前及治疗后1、2个月,两组关节活动度(range of motion,ROM)、最狭窄处脊髓面积、颈椎生理曲线、椎管横截面积比较,差异均无统计学意义(P>0.05)。两组不良事件总发生率比较,差异无统计学意义(P>0.05)。结论:ACDF、ACCF治疗双节段颈椎病的效果不存在明显差异,但ACDF手术时间较短,且出血量较少,更适用于对手术耐受度较低的患者。Objective:To analyze and compare the application effects of anterior cervical discectomy and fusion(ACDF)and anterior cervical corpectomy and fusion(ACCF)in the treatment of bilateral cervical spondylosis.Method:A total of 90 patients with double-segmental cervical spondylosis admitted to Huai’an 82 Hospital from December 2020 to December 2023 were selected and divided into control group and observation group using the latest statistical software to generate random sequences,with 45 cases in each group.The control group was treated with ACCF and the observation group was treated with ACDF.Perioperative indexes,pain relief,cervical function recovery and adverse events were compared between two groups.Result:Perioperative indexes(operation time,intraoperative bleeding blood volume,postoperative drainage volume,ambulation time and hospital stay)of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).There were no significant differences in numeric rating scales(NRS)scores between two groups before treatment,14 d and 1 month,2 months after treatment(P>0.05).There were no significant differences in range of motion(ROM),spinal cord area at the narrowest point,cervical curvature and vertebral canal cross-sectional area between two groups before treatment and 1 month,2 months after treatment(P>0.05).There was no significant difference in the total incidence of adverse events between two groups(P>0.05).Conclusion:There is no significant difference between ACDF and ACCF in the treatment of double-segmental cervical spondylosis,but ACDF is more suitable for patients with low tolerance to surgery because of its shorter operation time and less blood loss.

关 键 词：双节段颈椎病 颈椎前路椎间盘切除减压融合术 颈椎前路椎体次全切除减压融合术 围手术期 疼痛缓解 颈椎恢复 不良事件 

分 类 号：R687.3[医药卫生—骨科学]