| 椎动脉型颈椎病行颈前路椎间盘切除减压植骨融合术的疗效分析 |
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投稿时间：2023-03-01
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| 作者 | Author | 单位 | Address | E-Mail |
| 艾义翔 |
AI Yi-xiang |
西安交通大学附属红会医院脊柱外科, 陕西 西安 710054 |
Department of Spine Surgery, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 刘俭涛 |
LIU Jian-tao |
西安交通大学第一附属医院骨科, 陕西 西安 710061 |
Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 郝定均 |
HAO Ding-jun |
西安交通大学附属红会医院脊柱外科, 陕西 西安 710054 |
Department of Spine Surgery, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
haodingjun@mail.xjtu.edu.cn |
| 龚禧 |
GONG Xi |
西安交通大学第一附属医院骨科, 陕西 西安 710061 |
Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 朱以涵 |
ZHU Yi-han |
西安交通大学第一附属医院骨科, 陕西 西安 710061 |
Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 李幸橼 |
LI Xing-yuan |
西安交通大学第一附属医院骨科, 陕西 西安 710061 |
Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 张熙伟 |
ZHANG Xi-wei |
西安交通大学第一附属医院骨科, 陕西 西安 710061 |
Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 王考 |
WANG Kao |
西安交通大学第一附属医院骨科, 陕西 西安 710061 |
Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 孙佳俊 |
SUN Jia-jun |
西安交通大学第一附属医院骨科, 陕西 西安 710061 |
Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 张淑媛 |
ZHANG Shu-yuan |
西安交通大学第一附属医院骨科, 陕西 西安 710061 |
Department of Orthopaedics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第7期，第670-675页 |
| DOI：10.12200/j.issn.1003-0034.20221051 |
| 基金项目:国家自然科学基金重点项目(编号:81830077);陕西省重点研发计划(编号:2022GY-390); 西安交通大学第一附属医院科研发展基金(编号:2020QN-36) |
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中文摘要:
目的：探讨颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床效果。
方法：回顾性分析 2020 年 1 月至 2022 年 1 月42 例 CSA 患者的临床资料,男 25 例,女 17 例;年龄 30~74 (53.9±11.0)岁。单节段病变 18 例,2 个节段病变 17 例,3 个节段病变 7 例。分别在术前和术后 6 个月时采用美国耳鼻咽喉头颈外科学会听力及平衡委员会评分(Committeeon Hearing and Equilibrium,CHE)、颈椎功能障碍指数(neck disability index,NDI)和颈椎曲度 Cobb 角进行临床疗效评价。
结果：42 例患者均获随访,随访时间 6~30 (14.0±5.2)个月;手术时间 95~220(160.38±36.77) min,术中出血量 30~85(53.60±18.98) ml。2 例术后出现轻度吞咽困难,给予雾化吸入等对症处理后均好转。CHE 评分由术前(4.05±0.96)分降低至术后 6 个月的(2.40±0.70)分(t=12.97,P<0.05)。术后 6 个月 38 例眩晕改善,改善率 90.5%。NDI 评分的由术前的(34.43±8.04)分降低至术后 6 个月的(20.76±3.91)分(t=11.83,P<0.05)。颈椎曲度 Cobb 角由术前的(8.04±6.70)°提高至术后 6 个月的(12.42±5.23)°(t=-15.96,P<0.05)。
结论：ACDF 术式治疗椎动脉型颈椎病的临床疗效突出,手术通过解除骨性压迫,重建颈椎曲度,可快速缓解患者的发作性眩晕症状。但需要严格把握手术指征,明确患者眩晕原因,对保守治疗无效的 CSA 患者,ACDF 手术可推荐使用。 |
| 【关键词】椎动脉型颈椎病 颈前路椎间盘切除减压植骨融合术 颈性眩晕 |
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| Curative effect analysis of anterior cervical discectomy and fusion in patients with cervical spondylosis of vertebral artery type |
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ABSTRACT
Objective To investigate the clinical effect of anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylosis of vertebral artery type(CSA).
Methods The clinical data of 42 patients with CSA from January 2020 to January 2022 were retrospectively analyzed. There were 25 males and 17 females,aged from 30 to 74 years old with an average of (53.9±11.0) years old. There were 18 cases with single-segment lesions,17 cases with two segment lesions,and 7 cases with three segment lesions. The American Academy of Otolaryngology-Head and Neck Surgery's Hearing and Balance Committee score (CHE),the Neck Disability Index (NDI) and the cervical curvature Cobb angle were recorded before surgery and after surgery at 6 months.
Results All 42 ACDF patients were followed up for 6 to 30 months with an average of (14.0±5.2) months. The operative time ranged from 95 to 220 min with an average of (160.38±36.77) min,the intraoperative blood loss ranged from 30 to 85 ml with an average of (53.60±18.98) ml. Tow patients had mild postoperative dysphagia,which improved with symptomatic treatment such as nebulized inhalation. CHE score decreased from (4.05±0.96) preoperatively to (2.40±0.70) at 6 months postoperatively (t=12.97,P<0.05). The number of improved vertigo at 6 months postoperatively was 38,with an improvement rate of 90.5%. NDI score was reduced from (34.43±8.04) preoperatively to (20.76±3.91) at 6 months postoperatively (t=11.83,P<0.05). The cervical curvature Cobb angle improved from (8.04±6.70)° preoperatively to (12.42±5.23)° at 6 months postoperatively (t=-15.96,P<0.05).
Conclusion The ACDF procedure has outstanding clinical efficacy in treating CSA. The operation can rapidly relieve patients' episodic vertigo symptoms by relieving bony compression and reconstructing cervical curvature. However,it is necessary to strictly grasp the indications for surgery and clarify the causes of vertigo in patients,and ACDF surgery is recommended for CSA patients for whom conservative treatment is ineffective. |
| KEY WORDS Cervical spondylosis of vertebral artery type Anterior cervical discectomy and fusion Cervical vertigo |
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| 中文格式: | 艾义翔,刘俭涛,郝定均,龚禧,朱以涵,李幸橼,张熙伟,王考,孙佳俊,张淑媛.椎动脉型颈椎病行颈前路椎间盘切除减压植骨融合术的疗效分析[J].中国骨伤,2024,37(7):670~675 |
| 英文格式: | AI Yi-xiang,LIU Jian-tao,HAO Ding-jun,GONG Xi,ZHU Yi-han,LI Xing-yuan,ZHANG Xi-wei,WANG Kao,SUN Jia-jun,ZHANG Shu-yuan.Curative effect analysis of anterior cervical discectomy and fusion in patients with cervical spondylosis of vertebral artery type[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(7):670~675 |
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