摘要
目的:对比不同方式颈前路椎间盘切除植骨融合治疗多节段颈椎病疗效。方法:选取2012年2月至2018年5月收治的46例非连续性多节段颈椎病患者作为研究对象,随机分为跳跃式组和连续性组;跳跃式组患者进行跳跃式颈前路椎间盘切除植骨融合术治疗,连续性组患者进行连续性颈前路椎间盘切除植骨融合术治疗;比较两组患者手术前、手术后1周、3个月、12个月JOA评分,手术前、手术后3个月、12个月颈椎整体活动度、矢状面垂直轴距离、T1倾斜角、相邻节段椎间盘退变情况、术后并发症发生情况。结果:跳跃式组患者手术时间较连续性组缩短,术中出血量较连续性组减少(P<0.05);两组患者术后1周、3个月、12个月JOA评分与术前相比,均逐渐提高(P<0.05);术后3个月、12个月两组患者的颈椎整体活动度、T1倾斜角较术前提高(P<0.05);术后3个月两组患者矢状面垂直轴距离较术前增加(P<0.05);跳跃式组44个相邻节段8个椎间盘退变分级加重1级,连续性组46个相邻节段10个椎间盘退变分级加重1级,两组患者间相邻节段椎间盘退变情况差异无统计学意义(P>0.05);两组患者的并发症发生率差异无统计学意义(P>0.05)。结论:跳跃式颈前路椎间盘切除植骨融合术治疗非连续多节段颈椎病,手术时间缩短,术中出血量减少,与连续性颈前路椎间盘切除植骨融合术疗效相似,因此在治疗非连续多节段颈椎病推荐选择跳跃式颈前路椎间盘切除植骨融合术。
Objective:To compare and analyze the short-term effect of different methods of anterior cervical discectomy and bone grafting for multi-segment cervical spondylosis.Methods:46 patients with non-continuous multi-segment cervical spondylosis who were admitted from February 2012 to May 2018 were selected and divided into groups A and B randomly.Group A was was treated with anterior cervical discectomy and bone grafting,and group B was treated with continuous anterior cervical discectomy and bone graft fusion to compare surgical indicators,preoperative,postoperative 1 week,3 months,and 12 months JOA scores,preoperative,3 months,and 12 months postoperative cervical spine overall mobility,sagittal plane vertical axis distance,T1 tilt angle,the degeneration of adjacent intervertebral discs and the postoperative complications.Results:The operation time of group A was significantly shorter than that of group B.The amount of intraoperative blood loss was significantly lower than that of group B(P<0.05).The JOA scores of the two groups were significantly increased at 1 week,3 months and 12 months after operation(P<0.05),but there was no significant difference in JOA scores between the two groups before operation,1 week,3 months and 12 months after operation(P>0.05)and the cervical spine whole group before operation,3 months and 12 months after operation.There was no significant difference in activity,sagittal vertical axis distance and T1 tilt angle(P>0.05).The overall cervical motion and T1 tilt angle of the two groups were significantly higher than those before surgery(P<0.05).The distance between the sagittal plane and the vertical axis of the two groups was significantly increased(P<0.05),and the distance between the sagittal plane and the vertical axis of the two groups was not significantly different from that before surgery(P>0.05),8 adjacent segments of group A,8 disc degenerations were graded by grade 1,and 46 adjacent segments of group B were degraded by grade 1 disc degeneration,and the difference of intervertebral disc degeneration between adjacent groups.There was no statistical significance(P>0.05)and there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Jumping cervical anterior discectomy bone fusion for the treatment of non-continuous multi-segment cervical spondylosis has shortened operation time,the amount of intraoperative blood loss is reduced,the incidence of postoperative complications is significantly reduced,and it is equivalent to the treatment of continuous anterior cervical discectomy and bone graft fusion.Non-continuous multi-segment cervical spondylosis is recommended for anterior cervical anterior discectomy and bone graft fusion.
作者
陈炽森
CHEN Chisen(Dongguan Mayong Hospital, Dongguan 523000, China)
出处
《包头医学院学报》
CAS
2020年第2期9-11,25,共4页
Journal of Baotou Medical College
关键词
颈前路椎间盘切除
植骨融合
跳跃式
颈椎病
Anterior cervical discectomy
Bone graft fusion
Jumping
Cervical spondylosis
