颈前路椎间盘切除融合术与颈前路椎体次全切减压融合术治疗相邻两节段脊髓型颈椎病患者的临床疗效比较  

Comparison of the clinical efficacy of anterior cervical discectomy with fusion and a anterior cervical corpectomy with fusion in the treatment of patients with adjacent two segments of cervical spondylotic myelopathy

作　　者：王焱 单文翰 苟东凯 刘全敬 刘黄兴 WANG Yan;SHAN Wenhan;GOU Dongkai;LIU Quanjing;LIU Huangxing(Medical College of Tibet University,Lhasa,Tibet,850032,China)

机构地区：[1]西藏大学医学院,西藏拉萨850032

出　　处：《当代医学》2025年第1期103-107,共5页Contemporary Medicine

摘　　要：目的比较颈前路椎间盘切除融合(anterior cervical discectomy with fusion,ACDF)术与颈前路椎体次全切减压融合(anterior cervical corpectomy with fusion,ACCF)术治疗相邻两节段脊髓型颈椎病患者的临床疗效。方法选取2019年8月至2022年8月西藏军区总医院收治的70例相邻两节段脊髓型颈椎病患者作为研究对象,按照不同手术方式分为甲组与乙组,每组35例。甲组采取ACDF术治疗,乙组采取ACCF术治疗,比较两组手术相关指标、颈椎融合节段Cobb角和颈椎曲度、术后并发症发生情况、颈椎日本骨科协会(Japanese Orthopedic Association,JOA)评分。结果甲组手术时间长于乙组,术中出血量少于乙组,差异有统计学意义(P<0.05);术后12个月,两组颈椎融合节段Cobb角、颈椎曲度均大于术前,且甲组大于乙组,差异有统计学意义(P<0.05);两组术后并发症发生率比较差异无统计学意义;术后6个月,两组颈椎JOA评分均高于术前,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义。结论ACDF、ACCF术治疗相邻两节段脊髓型颈椎病的安全性及术后颈椎功能恢复效果相当,但ACDF术可明显改善患者颈椎融合节段Cobb角、颈椎曲度,减少术中出血量,而ACCF术手术时间更短,临床可酌情选择术式。Objective To investigate the clinical efficacy of anterior cervical discectomy with fusion(ACDF)and anterior cervical corpectomy with fusion(ACCF)in the treatment of patients with adjacent two segments of cervical spondylotic myelopathy.Methods 70 patients with cervical spondylotic myelopathy of adjacent two segments to the The General Hospital of the Tibet Military Region from August 2019 to August 2022 were selected as the research subjects,and they divided into the group A and the group B according to different surgical methods,with 35 cases in each group.The group A was treated with ACDF,and the group B was treated with ACCF,the operation-related indexes,Cobb angle and cervical curvature of cervical fusion segment,postoperative complications,and the Japanese Orthopedic Association(JOA)score of cervical spine were compared between the two groups.Results The operation time in the group A was longer than that in the group B,and the amount of intraoperative bleeding was less than that in the group B,and the differences were statistically significant(P<0.05);at 12 months after operation,Cobb angle and cervical curvature of cervical fusion segment of the two groups were greater than those before operation,and the group A was greater than the group B,and the differences were statistically significant(P<0.05);there was no significant difference in the incidence of postoperative complications between the two groups;at 6 months after operation,the JOA score of cervical spine of the two groups were higher than those before operation,and the differences were statistically significant,but there was no significant difference between the two groups.Conclusion ACDF and ACCF have the same safety and recovery effect of cervical spine function after operation in the treatment of patients with adjacent two segments of cervical spondylotic myelopathy,but ACDF can significantly improve the Cobb angle and cervical curvature of cervical fusion segment,reduce the amount of intraoperative bleeding,while ACCF has shorter operation time

关 键 词：相邻两节段脊髓型颈椎病 颈前路椎间盘切除融合术 颈前路椎体次全切减压融合术 颈椎融合节段Cobb角 颈椎曲度 并发症 

分 类 号：R687.3[医药卫生—骨科学]