摘要
目的探讨微创内镜辅助下颈椎前路椎间盘切除融合术(MOEA-ACDF)与显微镜辅助下颈椎前路椎间盘切除融合术(M-ACDF)治疗脊髓型颈椎病(CSM)的疗效。方法回顾性选取2022年1月—2023年5月于滨州医学院附属医院脊柱外科收治的43例老年CSM患者,其中23例行MOEA-ACDF治疗(设为MOEA-ACDF组),20例行M-ACDF治疗(设为M-ACDF组)。采用单因素比较评估MOEA-ACDF及M-ACDF治疗脊髓型颈椎病的疗效。结果所有患者均顺利完成手术,且无严重并发症发生。与M-ACDF组相比,MOEA-ACDF组手术时间、下地时间、住院时间、颈托摘除时间差异均无统计学意义(P>0.05),但切口长度、出血量、引流量明显减小(P<0.05)。2组术前、术后3 d、术后1个月、术后6个月、末次随访时的VAS评分、NDI评分、JOA评分差异均无统计学意义(P>0.05),但术后VAS评分、NDI评分均较术前降低(P<0.05),JOA评分均较术前升高(P<0.05)。影像测量上,2组术后颈椎管矢状径、椎间隙高度均无统计学意义(P>0.05),但MOEA-ACDF组压迫物残余率减小(P<0.05)。结论MOEA-ACDF及M-ACDF均可有效治疗CSM,但MOEA-ACDF可能是创伤更小、术后压迫物残余更少的微创手术治疗方式。
Objective To compare the efficacy of minimally invasive endoscopy-assisted anterior cervical discectomy and fusion(MOEA-ACDF)and microscopy-assisted anterior cervical discectomy and fusion(M-ACDF)in the treatment of cervical spondylotic myelopathy(CSM).Methods A retrospective study was conducted on 43 elderly CSM patients admitted to Department of Spinal Surgery of Affiliated Hospital of Binzhou Medical University from January 2022 to May 2023.Among them,23 patients underwent with MOEA-ACDF(assigned to MOEA-ACDF group)and 20 ones did M-ACDF(assigned to M-ACDF group).Univariate analysis was used to compare and evaluate the efficacy of the two methods in the treatment of cervical spondylotic myelopathy.Results All patients successfully completed surgery without serious complications.There was no significant difference in operation time,time to get out of bed,hospital stay and neck support removal time between the two groups(P>0.05),but the incision length,bleeding volume and drainage volume in the MOEA-ACDF group were significantly shorter or less than those in the M-ACDF group(P<0.05).There was no significant difference in the scores of Visual Analog Scale(VAS),Neck Disability Index(NDI),and Japanese Orthopaedic Association(JOA)between the two groups before surgery,3 days after surgery,1 month after surgery,6 months after surgery,and at the last follow-up(P>0.05).However,the scores of VAS and NDI gradually decreased(P<0.05)and the JOA scores gradually increased(P<0.05)after surgery in both groups.In terms of imaging measurement,there was no statistically significant difference in the sagittal diameter and intervertebral height of the cervical canal between the two groups after surgery(P>0.05),but the residual compression rate in the MOEA-ACDF group was significantly lower than that in the M-ACDF group(P<0.05).Conclusion Both MOEA-ACDF and M-ACDF can effectively treat CSM,but MOEA-ACDF is a minimally invasive surgical treatment with fewer traumas and less postoperative compression residue.
作者
马恩腾
周奕洁
赵加庆
王大巍
耿晓鹏
Ma Enteng;Zhou Yijie;Zhao Jiaqing;Wang Dawei;Geng Xiaopeng(Affiliated Hospital of Binzhou Medical University,Binzhou,Shandong,256603,P.R.China;Traditional Chinese Medicine Hospital of Pingyi County,Pingyi,Shandong,273300,P.R.China)
出处
《老年医学与保健》
2025年第1期209-214,218,共7页
Geriatrics & Health Care
基金
山东省自然科学基金资助项目(ZR2017LH020)。
关键词
老年
脊髓型颈椎病
单侧双通道内镜系统
颈椎前路椎间盘切除融合术
elderly
cervical spondylotic myelopathy
unilateral two-channel endoscopic system
anterior cervical discectomy and fusion
