ACDF和ACCF治疗多节段颈椎病临床疗效的对比分析

发布时间：2018-05-07 01:24

本文选题：多节段颈椎病 + 椎间盘切除　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的对比分析颈前路椎间盘切除植骨融合术(ACDF)和椎体次全切除减压植骨融合术(ACCF)两种术式治疗多节段颈椎病的临床疗效。方法对2014年3月到2015年3月该院收治的单节段颈椎病患者的临床资料及影像学资料进行回顾性研究,符合要求的病历共26例,其中13例行颈前路椎间盘切除植骨融合术(ACDF),13例行颈前路椎间盘切除植骨融合术(ACCF)。统计两组的手术时间、术中出血量、住院时间、椎间高度的丢失、Cobb角的丢失以及对吞咽困难的发生率、植骨融合率,术前和术后3月、6月、12月VAS评分、NDI评分、JOA评分进行比较。结果所有患者均随访12个月,ACDF组在手术时间、术中出血量、平均住院日,椎间高度的丢失、Cobb角的丢失均优于ACCF组(P0.05),两组在术后均出现了不同程度的吞咽困难,但术后6月症状均消失;两组术后VAS评分、NDI评分、JOA评分、融合率无明显差异(P0.05)。结论两种手术方式治疗多节段颈椎病都能获得满意的临床效果,ACDF具有手术时间短、出血量少、住院时间短等优点,但ACDF并不能完全替代ACCF,手术方式需根据患者的具体情况而定。
[Abstract]:Objective to compare the clinical effects of anterior cervical disc resection and bone graft fusion (ACDF) and subtotal decompression and bone graft fusion (ACCF) in the treatment of multilevel cervical spondylosis. Methods from March 2014 to March 2015, the clinical and imaging data of patients with single-level cervical spondylosis were retrospectively studied. Anterior cervical discectomy and bone graft fusion were performed in 13 cases and anterior cervical discectomy and bone graft fusion were performed in 13 cases. The operation time, intraoperative bleeding volume, hospitalization time, loss of intervertebral height loss of Cobb angle, incidence of dysphagia, bone graft fusion rate, preoperative and postoperative 3 months, 6 months and 12 months after operation were compared between the two groups. Results all the patients were followed up for 12 months. The time of operation, the amount of blood lost during operation, the average days of hospitalization and the loss of Cobb angle of intervertebral height in ACDF group were better than those in ACCF group (P 0.05). The dysphagia occurred in different degree after operation in both groups. However, the symptoms disappeared at 6 months after operation, and there was no significant difference in the fusion rate between the two groups in terms of VAS score and VAS score and JOA score. Conclusion both of the two surgical methods can obtain satisfactory clinical results in the treatment of multilevel cervical spondylopathy. ACDF has the advantages of short operative time, less bleeding, and short hospitalization time. However, ACDF is not a complete substitute for ACCF, and the operation method should be determined according to the specific conditions of the patients.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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