| 显微镜辅助下前路颈椎间盘切除减压椎间植骨融合术治疗单节段脊髓型颈椎病 |
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Received:November 20, 2020
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| 作者 | Author | 单位 | Unit | E-Mail |
| 许宇霞 |
XU Yu-xia |
南华大学附属长沙中心医院脊柱外科, 湖南 长沙 410004 |
Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha 410004, Hunan, China |
2985507743@qq.com |
| 罗琦山 |
LUO Qi-shan |
南华大学附属长沙中心医院脊柱外科, 湖南 长沙 410004 |
Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha 410004, Hunan, China |
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| 李远红 |
LI Yuan-hong |
南华大学附属长沙中心医院脊柱外科, 湖南 长沙 410004 |
Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha 410004, Hunan, China |
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| 王永福 |
WANG Yong-fu |
南华大学附属长沙中心医院脊柱外科, 湖南 长沙 410004 |
Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha 410004, Hunan, China |
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| 罗一 |
LUO Yi |
南华大学附属长沙中心医院脊柱外科, 湖南 长沙 410004 |
Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha 410004, Hunan, China |
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| 王强 |
WANG Qiang |
南华大学附属长沙中心医院脊柱外科, 湖南 长沙 410004 |
Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha 410004, Hunan, China |
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| 罗为民 |
LUO Wei-min |
南华大学附属长沙中心医院脊柱外科, 湖南 长沙 410004 |
Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha 410004, Hunan, China |
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| 期刊信息：《中国骨伤》2021年34卷，第4期，第327-332页 |
| DOI：10.12200/j.issn.1003-0034.2021.04.006 |
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目的： 比较显微镜辅助下前路颈椎间盘切除减压椎间植骨融合术（anterior cervical discectomy and fusion，ACDF）与常规ACDF术治疗单节段脊髓型颈椎病的临床疗效。
方法： 回顾性分析2015年3月至2019年3月收治的89例单节段脊髓型颈椎病患者，男55例，女34例，年龄（52.00±11.36）岁；其中34例采用常规ACDF术治疗（常规组），C3，4 3例，C4，5 10例，C5，6 15例，C6，7 6例；55例采用显微镜辅助下ACDF术治疗（显微镜组），C3，4 5例，C4，5 23例，C5，6 20例，C6，7 7例。比较两组患者的手术时间、术中失血量、住院时间。术后1周、3个月、12个月采用日本骨科学会（Japanese Orthopaedic Association，JOA）评分标准，视觉疼痛模拟评分（visual analogue scale，VAS），Oswestry功能障碍指数（Oswestry Disability Index，ODI）进行临床疗效评估。
结果： 显微镜组失血量及住院时间均小于常规组（P<0.05），而常规组手术时间少于显微镜组（P<0.05）。两组患者术后1周、3个月及12个月JOA、VAS、ODI评分均较术前有明显改善（P<0.05）。尽管两组患者术后12个月比较差异无统计学意义（P>0.05），但术后1周、3个月显微镜组VAS评分低于常规组（P<0.05）；显微镜组每次随访的JOA评分均高于常规组（P<0.05）；术后3、12个月时显微镜组的ODI评分也优于常规组（P<0.05）。
结论： 显微镜辅助下ACDF术与同期常规ACDF术治疗单节段脊髓型颈椎病均能取得满意的临床疗效。但显微镜下行ACDF术具有视野清晰、出血少及术中并发症少的优势。 |
| [关键词]:脊髓型颈椎病 椎间盘切除 脊柱融合术 显微镜 |
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| Microscope assisted anterior cervical discectomy and fusion for the treatment of single-segment cervical spondylotic myelopathy |
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Abstract:
Objective: To compare the efficacy of microscope assisted anterior cervical discectomy and fusion with conventional surgical approach in the treatment of single-segment cervical spondylotic myelopathy.
Methods: The clinical data of 89 patients with single-segment cervical spondylotic myelopathy treated from March 2015 to March 2019 were retrospectively analyzed. There were 55 males and 34 females,with an average of (52.00±11.36) years old. Among the patients,34 cases were treated with conventional anterior cervical discectomy with fusion (conventional group),including C3,4 in 3 cases,C4,5 in 10 cases,C5,6 in 15 cases,C6,7 in 6 cases; 55 cases were treated with microscope-assisted anterior cervical discectomy with fusion (microscope group),including C3,4 in 5 cases,C4,5 in 23 cases,C5,6 in 20 cases,C6,7 in 7 cases. Operative time,intraoperative blood loss,hospital stay and complications were compared between two groups. Clinical efficacy was assessed by visual analogue scale(VAS),Japanese Orthopaedics Association (JOA) scores,Oswestry Disability Index(ODI) during follow-up period (postoperative 1 week,3 months and 12 months).
Results: Intraoperative blood loss and hospital stay in microscope group were less than those in conventional group (P<0.05),and operative time of conventional group was shorter than that of microscope group (P<0.05). Postoperative JOA,VAS and ODI were significantly improved in each groups (P<0.05). VAS scores of microscope group were better than that of conventional group at 1 week and 3 months after operation(P<0.05),but there was no statistically significant difference between two groups at 12 months after operation(P>0.05). JOA scores of microscope group at each postoperative follow-up were better than that of conventional group(P<0.05). ODI scores of microscope group at 3,12 months after operation were better than that of conventional group (P<0.05).
Conclusion: Both methods can achieve satisfactory effect in treating single-segment cervical spondylotic myelopathy. However,microscope-assisted anterior cervical discectomy and fusion has advantages of clear vision,less bleeding and fewer intraoperative complications. |
| KEYWORDS:Cervical spondylotic myelopathy Discectomy Spinal fusion Microscope |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 许宇霞,罗琦山,李远红,王永福,罗一,王强,罗为民.显微镜辅助下前路颈椎间盘切除减压椎间植骨融合术治疗单节段脊髓型颈椎病[J].中国骨伤,2021,34(4):327~332 |
| 英文格式: | XU Yu-xia,LUO Qi-shan,LI Yuan-hong,WANG Yong-fu,LUO Yi,WANG Qiang,LUO Wei-min.Microscope assisted anterior cervical discectomy and fusion for the treatment of single-segment cervical spondylotic myelopathy[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(4):327~332 |
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