摘要
目的比较颈前路椎体次全切除融合术(ACCF)与颈前路椎间盘切除融合术(ACDF)治疗脊髓型颈椎病的效果及对颈椎生物力学特征、功能状态的影响。方法选取2018年1月至2020年12月收治的90例脊髓型颈椎病患者,按照手术方案差异将其分为对照组和观察组,各45例。对照组行ACCF,观察组行ACDF。比较两组的治疗效果。结果观察组的手术时长、住院时间短于对照组,术中出血量少于对照组(P<0.05)。术后3、6个月,观察组的颈椎曲度、T_(1)倾斜角、颈椎总活动度、融合节段Cobb角优于对照组(P<0.05)。术后3、6个月,观察组的颈椎功能障碍指数(NDI)、日本骨科协会(JOA)评分优于对照组(P<0.05)。术后3个月内,观察组的并发症总发生率略低于对照组,但差异不显著(P>0.05)。结论ACCF、ACDF治疗脊髓型颈椎病患者的长期疗效相近,均可有效改善颈椎生物力学特征及功能状态,但短期内ACDF具有创伤小、恢复快等优势。
Objective To compare the effects of anterior cervical corpectomy and fusion(ACCF)and anterior cervical discectomy and fusion(ACDF)in the treatment of cervical spondylotic myelopathy and its influences on the biomechanical characteristics and functional status of cervical spine.Methods A total of 90 patients with cervical spondylotic myelopathy admitted from January 2018 to December 2020 were selected.According to the difference of surgical plan,the patients were divided into control group and observation group,with 45 cases in each group.The control group was treated with ACCF,and the observation group was treated with ACDF.The therapeutic effects of the two groups were compared.Results The operation time and hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).At 3 and 6 months after operation,the cervical curvature,T_(1)tilt angle,total cervical mobility and Cobb angle of fusion segment in the observation group were better than those in the control group(P<0.05).At 3 and 6 months after operation,the Neck Disability Index(NDI)and Japanese Orthopaedic Association(JOA)scores of the observation group were better than those of the control group(P<0.05).Within 3 months after operation,the total incidence of complications in the observation group was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion The ACCF and ACDF in the treatment of cervical spondylotic myelopathy has similar long-term efficacy,and can effectively improve the biomechanical characteristics and functional status of cervical spine.However,ACDF has the advantages of less trauma,faster recovery and so on in the short term.
作者
田夏威
吴卓
王自立
贺西京
吴猛猛
许正伟
TIAN Xiawei;WU Zhuo;WANG Zili;HE Xijing;WU Mengmeng;XU Zhengwei(Xi'an International Medical Center Hospital,Xi'an 710100;Xi'an Honghui Hospital,Xi'an 710054,China)
出处
《临床医学研究与实践》
2023年第35期23-26,共4页
Clinical Research and Practice
基金
陕西省自然科学基础研究计划项目(No.2021JM-571)。
关键词
脊髓型颈椎病
颈前路椎体次全切除融合术
颈前路椎间盘切除融合术
颈椎生物力学特征
颈椎功能
cervical spondylotic myelopathy
anterior cervical corpectomy and fusion
anterior cervical discectomy and fusion
biomechanical characteristics of cervical spine
cervical function
