显微镜下前路颈椎手术与传统开放前路颈椎手术治疗颈椎病临床对比分析

发布时间：2018-04-11 14:29

本文选题：颈椎病 + 显微镜椎间盘摘除术　；参考：《遵义医学院》2017年硕士论文

【摘要】：目的:通过对比直视下颈前路手术,探讨显微镜下行前路颈椎间盘摘除cage植骨融合钛板内固定术治疗颈椎病的优点。方法:对2009年-2016年大连大学附属中山医院骨三科行手术治疗的符合入选标准的156例颈椎病的临床资料进行回顾性分析。按手术方式分为显微镜手术组(A组)108例及开放手术组(B组)48例。(1)比较两组患者在性别、年龄、病变节段构成、术前Cobb角度、体质指数(BMI)、JOA评分、颈部及上肢VAS评分、NDI评分,明确两组患者是否具备可比性;(2)比较两组患者手术切口长度、手术时间、术中出血量、术后并发症、住院时间是否存在差异;(3)比较两组患者术前及术后JOA评分、颈部及上肢VAS评分、NDI评分、影像学表现(融合节段椎间隙高度、Cobb角度)等指标判定临床疗效。结果:(1)两组患者在性别、年龄、病变节段构成、术前Cobb角度、BMI、JOA评分、颈部及上肢VAS评分、NDI评分差异无统计学意义(P0.05),两组具备可比性;(2)A组患者与B组患者比较,手术切口长度更短、手术时间更短、术中出血量更少、术后并发症发生率更低、住院时间更短(P0.05);(3)两组患者术后JOA评分、颈部及上肢VAS评分、NDI评分、影像学表现(融合节段椎间隙高度、Cobb角度)均较术前明显改善(P0.05),两组术后JOA评分、颈部及上肢VAS评分、NDI评分、影像学表现(融合节段椎间隙高度、Cobb角度)差异均无统计学意义(P0.05)。结论:应用显微镜行颈前路融合手术与直视下颈椎前路融合手术治疗颈椎病均可取得良好的治疗效果,显微镜下手术具有切口小、损伤小、出血少、术后并发症的发生率低、住院时间短的优点,且近期疗效更满意。
[Abstract]:Objective: to investigate the advantages of anterior cervical intervertebral disc removal (cage) and fusion titanium plate fixation under direct vision for cervical spondylosis.Methods: the clinical data of 156 patients with cervical spondylosis who were treated by surgery in three departments of Zhongshan Hospital affiliated to Dalian University from 2009 to 2016 were analyzed retrospectively.According to the operation mode, 108 patients were divided into two groups: group A (n = 108) and group B (n = 48). Sex, age, pathological segment composition, preoperative Cobb angle, body mass index (BMI) and VAS score of neck and upper extremity were compared.To compare the operative incision length, operation time, intraoperative bleeding volume, postoperative complications and hospitalization time between the two groups, and to compare the JOA scores between the two groups before and after operation.Cervical and upper limb VAS scores and imaging findings (fusion height of intervertebral space and Cobb angle) were used to evaluate the clinical efficacy.The length of incision was shorter, the operative time was shorter, the amount of intraoperative bleeding was less, the incidence of postoperative complications was lower, and the hospitalization time was shorter (P0.05).There was no significant difference between the two groups in JOA score, neck and upper extremity VAS score, and the imaging manifestation (fusion level of intervertebral space height and Cobb angle) between the two groups (P 0.05), and there was no significant difference between the two groups in the imaging manifestations (fusion segment height of intervertebral space and Cobb angle) before and after operation (P 0.05).Conclusion: the treatment of cervical spondylosis by anterior cervical fusion under microscope and anterior fusion of cervical vertebrae under direct vision can achieve good results. The operation under microscope has the advantages of small incision, little injury, less bleeding, and low incidence of postoperative complications.The advantages of short hospital stay are more satisfactory in the near future.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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