颈前路3种术式治疗单节段神经根型颈椎病的对比研究  

Comparision of three kinds of anterior cervical surgeries for single-segment cervical spondylotic radiculopathy

作　　者：刘涛[1] 支中正 周付超 潘伟成 张荣程 何志敏 吴德盛 LIU Tao;ZHI Zhongzheng;ZHOU Fuchao;PAN Weicheng;ZHANG Rongcheng;HE Zhimin;WU Desheng(Department of Spine Surgery,Shanghai Fourth People′s Hospital Affiliated to Tongji University,Shanghai 200434;Department of Orthopedics,Chongqing Medical University Affiliated Bishan Hospital(People′s Hospital of Bishan District,Chongqing),Chongqing 402760)

机构地区：[1]同济大学附属上海市第四人民医院脊柱外科,上海200434 [2]重庆医科大学附属璧山医院(重庆市璧山区人民医院)骨科,重庆402760

出　　处：《颈腰痛杂志》2025年第1期60-64,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：上海市虹口区临床重点专科项目(HKLCZD2024B03)。

摘　　要：目的探讨低温等离子射频消融术(CA)、颈前路减压椎间融合术(ACDF)及人工颈椎间盘置换术(CADR)治疗单节段神经根型颈椎病(CSR)的临床疗效。方法回顾纳入2019年1月至2020年12月于上海市第四人民医院脊柱外科因C 5/6单节段CSR接受颈前路CA(A组)、ACDF(B组)和CADR(C组)手术患者共171例,其中A组56例,B组57例,C组58例。记录术前及术后各随访时间点神经功能日本骨科协会脊髓功能评分(JOA),颈、臂部疼痛评分及颈椎功能受损指数(NDI)并进行比较。结果三组纳入患者年龄及随访时间差异无统计学意义(P>0.05),手术时间及术中出血量差异有统计学意义(P<0.05)。三组组内术后各随访时间点与术前相比,参数变化差异均有统计学意义(P<0.01)。组间术后6个月、12个月脊髓神经功能JOA评分、颈及臂疼痛评分差异有统计学意义(P<0.01),术后3个月、6个月、12个月NDI差异均有统计学意义(P<0.01)。结论低温等离子射频消融术、ACDF及CADR治疗C 5/6单节段CSR可有效缓解患者疼痛,促进神经功能恢复。从疼痛缓解、脊髓神经及颈椎功能恢复时间方面比较,ACDF及CADR更优。Objective To investigate the clinical efficacy of low-temperature plasma radiofrequency ablation(CA),anterior cervical discectomy and fusion(ACDF),and cervical artificial disc replacement(CADR)in treating single-level cervical spondylotic radiculopathy(CSR).Methods A retrospective study was conducted on 171 patients who underwent CA(Group A,n=56),ACDF(Group B,n=57),or CADR(Group C,n=58)for C 5/6 single-level CSR at the Spinal Surgery Department of the Fourth People′s Hospital of Shanghai from January 2019 to December 2020.Neurological function was assessed using the Japanese Orthopaedic Association(JOA)score,neck and arm pain were evaluated with the visual analog scale(VAS),and cervical spine function impairment was measured with the neck disability index(NDI).These scores were recorded preoperatively and at various follow-up intervals postoperatively and compared among groups.Results There were no statistically significant differences in age and follow-up duration among the three groups(P>0.05).However,there were statistically significant differences in operation time and intraoperative blood loss(P<0.05).Within each group,there were statistically significant changes in all parameters from baseline to each follow-up interval postoperatively(P<0.01).Between groups,there were statistically significant differences in JOA scores,VAS scores for neck and arm pain,and NDI at 6 and 12 months postoperatively(P<0.01).Conclusion Low-temperature plasma radiofrequency ablation,ACDF,and CADR are effective treatments for relieving pain and promoting neurological recovery in patients with C 5/6 single-level cervical spondylotic radiculopathy.In terms of pain relief and recovery of spinal nerve and cervical spine function,ACDF and CADR surgeries offer superior outcomes.

关 键 词：神经根型颈椎病 前路 低温等离子射频消融术 颈前路减压椎间融合术 人工颈椎间盘置换术 

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