摘要
目的分析颈前路减压融合手术治疗3节段脊髓型颈椎病的临床疗效。方法对124例3节段脊髓型颈椎病患者行颈前路手术治疗,78例行颈前路椎间盘切除减压融合术(ACDF),46例行颈前路椎体次全切除减压融合术(ACCF)。评估术后JOA评分及其改善率、植骨融合情况以及颈椎曲度。结果患者均获得随访,时间:ACDF组13~54(36.7±15.1)个月,ACCF组14~53(33.6±18.7)个月。两组患者术后JOA评分及颈椎Cobb角均较术前显著提高及恢复,差异均有统计学意义(P<0.05)。ACDF组在手术时间、术中出血量及颈椎生理曲度恢复程度方面均优于ACCF组,且并发症发生率更低(P<0.05)。两组术后JOA评分及其改善率、植骨融合率比较差异无统计学意义(P>0.05)。结论 ACDF与ACCF治疗3节段脊髓型颈椎病均可达到满意的神经功能恢复;ACDF治疗后颈椎生理曲度恢复较好,且并发症发生率较低。
Objective To analyze the clinical outcomes of anterior cervical decompression and interbody fusion for three-segmental cervical spondylotic myelopathy. Methods A retrospective analysis was performed on 124 cases with three-segmental cervical spondylotic myelopathy who had undergone anterior cervical decompression. The pa-tients were divided into anterior cervical discectomy and fusion（ ACDF） group （78 cases） and anterior cervical cor-pectomy and fusion（ACCF） group（46 cases）. The operative effects were evaluated by using the JOA scores and im-provement rates, fusion rates and cervical curvatures. Results All cases were followed up for 13 ？54 （ 36. 7 土 15. 1） months in ACDF group and 14 ？53 （ 33. 6 ± 18. 7） months in ACCF group. The postoperative JOA scores and cervical Cobb angles of two groups were significantly improved and regained, compared with preoperative ones （P 〈 0. 05） . But ACDF group had better results in operation time, intraoperative blood loss, cervical curvature and opera-tive complication than ACCF group （P 〈0. 05）. The postoperative JOA scores, improvement rate and bone graft fu-sion rate between the two groups were not statistically significant （ P 〉 0. 05 ） . Conclusions The postoperative neu-ral functional recovery after ACDF procedure or ACCF procedure is satisfactory for three-segmental cervical spondylot-ic myelopathy. Meanwhile, ACDF procedure has better result in restoring cervical physiological curvature and lower incidence rate of postoperative complications.
出处
《临床骨科杂志》
2017年第4期390-393,397,共5页
Journal of Clinical Orthopaedics
关键词
多节段脊髓型颈椎病
前路减压
multi-segmental cervical spondylotic myelopathy
anterior cervical decompression
