摘要
目的比较颈前路椎间盘切除植骨融合术(ACDF)和颈前路椎体次全切除融合术(ACCF)对邻近双节段脊髓型颈椎病的治疗效果。方法回顾性分析在我院接受手术治疗的邻近双节段脊髓型颈椎病的50例患者,其中采用颈前路椎间盘切除植骨融合术的患者25例(ACDF组),采用颈前路椎体次全切除融合术的患者25例(ACCF组)。比较两组患者的手术时间、住院时间、出血量,JOA评分和VAS评分以及两组患者手术前后的颈椎曲度和融合节段高度。结果 ACCF组手术时间明显低于ACDF组,术中的出血量明显多于ACDF组(P<0.05),但住院时间差异不具有统计学意义(P>0.05);两组患者手术后的JOA评分明显高于手术前,VAS评分明显低于手术前(P<0.05);但两组患者间的JOA评分和VAS评分差异不具有统计学意义(P>0.05)。两组患者手术前的颈椎曲度差异不具有统计学意义(P>0.05),手术后3 d以及术后1年随访,ACCF组中患者的颈椎曲度明显小于ACDF组(P<0.05);两组融合节段高度均明显高于手术前(P<0.05),但两组患者手术前后的融合节段高度差异不明显。结论 ACDF具有出血量少,能更好地改善颈椎曲度,但ACCF具有手术时间短的优点。临床医师应根据患者的实际情况,采用适当的手术方式治疗邻近双节段脊髓型颈椎病。
Objective To compare the therapeutic effect of the anterior cervical discectomy with fusion （ACDF） and anterior cervical corpectomy and fusion （ACCF） of adjacent double segment spondylotic cervical spondylosis for decompression and fusion. Methods Retrospective analysis was used in 50 patients of adjacent double segments cervical spondylotic myelopathy underwent operation treatment in our hospital, in which there were 25 cases of ACDF group underwent anterior cervical discectomy with fusion, and the other 25 patients of AC- CF group underwent anterior cervical corpectomy and fusion. The operation time, the hospitalization time, the a- mount of bleeding, the JOA score, the VAS score and the cervical lordosis and fusion segments height before and after surgery of the two groups were compared. Results The operation time of the ACCF group was significant- ly lower than that in ACDF grQup, and the bleeding volume was significantly higher than that of the ACDF group （P 〈 0. 05）. There was no statistically significant in the hospitalization time. The JOA score of two groups was significantly higher than that before operation （P 〈 0.05 ）. The VAS score was significantly lower than that before operation （P 〈 0.05 ）. But the difference of the JOA score and VAS score between the two groups was not statisti- cally significant （P 〉 0. 05）. The cervical curvature of the two groups of patients before surgery had no statistical significance （P 〉 0.05 ）. The cervical curvature of the ACCF group after 3 weeks of operation and after 1 years of follow-up was significantly lower than in group ACDF （P 〈 0.05）. The fusion segment height ot two groups were significantly higher than that before operation （P 〈 0.05 ）, but the difference was not statistically significant between the two groups. Conclusion ACDF can improve the cervical curvature with less blood loss, and ACE has the advantage of short operation time. Clinicians should use the proper operation treatment for adjacent double segments cervical spondylotic myelopathy patients according to the actual situation.
出处
《中国现代手术学杂志》
2016年第1期48-50,共3页
Chinese Journal of Modern Operative Surgery
关键词
椎管成形术
减压术
外科
颈椎病
spinal canatoplasty
decompression
cervical spondylosis
