摘要
背景:多节段脊髓型颈椎病的手术治疗可以采用前路手术和后路手术,但是关于修复方式的选择目前仍存有争议。目的:探讨颈椎前路椎体次全切除植骨融合和后路单开门椎管扩大成形对多节段脊髓型颈椎病患者的疗效,尤其是对患者颈椎活动度的影响。方法:回顾性分析2016年1月至2018年1月在青海大学附属医院就诊的多节段脊髓型颈椎病患者的病历资料,按照手术方式分为前路组和后路组,其中前路组33例采取颈椎前路椎间盘切除植骨融合治疗,后路组32例采取单开门椎管扩大成形治疗。采用日本骨科协会评分评估两组患者术前及术后神经功能,测量两组患者术前及术后的颈椎活动度。结果与结论:①65例多节段脊髓型颈椎病患者均完成随访,随访时间12-25个月;②两组患者年龄、性别构成、随访时间、术前及术后末次随访时日本骨科协会评分相比,差异无显著性意义(P>0.05);③两组患者术后的颈椎活动度均较术前有所减少(P<0.05);末次随访时后路组在前屈、后伸、左侧屈、右侧屈、左旋及右旋方向上的颈椎活动度均优于前路组;④提示多节段脊髓型颈椎病患者接受颈椎前路椎体次全切除植骨融合和后路单开门椎管扩大成形治疗后颈椎活动度均减小,且前者较后者对颈椎活动度的影响更大。
BACKGROUND:Anterior approach and posterior approach are used in the treatment of multilevel cervical spondylotic myelopathy,but it is still controversial about the choice of surgical approach.OBECTIVE:To investigate the effects of anterior corpectomy and fusion versus posterior single open-door laminoplasty on cervical range of motion of patients with multilevel cervical spondylotic myelopathy.METHODS:Medical records of patients with multilevel cervical spondylotic myelopathy admitted in Affiliated Hospital of Qinghai University from January 2016 to January 2018 were retrospectively analyzed.According to surgical approaches,they were divided into anterior and posterior groups.Patients in the anterior group(n=33)were treated with anterior corpectomy and fusion,while patients in the posterior group(n=32)were treated with posterior single open-door laminoplasty.The Japanese Orthopaedic Association score was used to evaluate the neurological function before and after surgery in both groups.Cervical range of motion before and after operation was measured in both groups.RESULTS AND CONCLUSION:(1)A total of 65 patients with multilevel cervical spondylotic myelopathy were followed up.The follow-up time ranged from 12 to 25 months.(2)There were no significant differences in age,gender composition,follow-up time,and Japanese Orthopaedic Association score between the two groups before surgery and at the time of the last follow-up(P>0.05).(3)Cervical range of motion of the two groups after surgery was reduced compared with those before surgery(P<0.05).The ranges of motion of cervical spine in the posterior group were better than those in the anterior group in flexion,extension,left flexion,right flexion,left rotation and right rotation at the last follow-up.(4)It is indicated that the range of motion of cervical spine was reduced after both anterior corpectomy and fusion and laminoplasty in patients with multilevel cervical spondylotic myelopathy,and the former has more influence on the cervical range of motion than the latter.
作者
张启福
马永红
王涛
胡一博
张鹤令
宗群川
Zhang Qifu;Ma Yonghong;Wang Tao;Hu Yibo;Zhang Heling;Zong Qunchuan(Department of Orthopedic Trauma,2Department of Endocrinology,Affiliated Hospital of Qinghai University,Xining 810000,Qinghai Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第24期3870-3874,共5页
Chinese Journal of Tissue Engineering Research
基金
青海大学附属医院中青年科研基金项目(ASRF-2014-10),项目负责人:张启福。
关键词
脊髓型颈椎病
颈椎前路
植骨融合
后路单开门
活动度
cervical spondylotic myelopathy
anterior cervical approach
bone grafting and fusion
posterior single door opening
range of motion
