颈椎前路椎间盘切除融合术对颈椎矢状面平衡改变和疗效分析

发布时间：2018-05-08 00:25

本文选题：颈椎矢状位参数 + 颈椎病　；参考：《南京医科大学学报(自然科学版)》2017年12期

【摘要】：目的 :研究颈椎前路椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)对颈椎矢状面参数的影响及临床疗效;不同节段个数ACDF手术之间的差异。方法:回顾性分析2013年2月—2016年1月在南京医科大学第一附属医院行ACDF手术的52例颈椎间盘突出症患者。在MRI上测量手术前后的颈椎矢状面参数,包括C0C2角、C2C7角、T1倾斜角、颈倾角和胸廓入口角。临床疗效通过疼痛视觉模拟评分(visual analogue scale,VAS)和日本骨科学会(Japanese Orthopaedic Association Scores,JOA)评分进行评估,对所得结果进行统计学分析。结果 :术后C2C7角、T1倾斜角较术前增大,颈倾角较术前减小(P0.05),术后VAS与JOA评分较术前均明显改善(P0.05);单节段、双节段和多节段手术在手术时间、出血量上存在差异(P=0.001),在颈椎矢状位参数手术前后的差值以及治疗改善率上三者之间无明显差异。结论 :颈椎前路椎间盘切除融合术治疗颈椎病疗效确切,手术通过改变颈椎曲度、增大T1倾斜角来恢复颈椎矢状位的平衡,不同节段个数的颈椎手术,在颈椎矢状位参数的改变和治疗改善率上无明显差异。
[Abstract]:Objective: To study the effect and clinical effect of anterior cervical discectomy and fusion (ACDF) on the sagittal plane parameters of cervical vertebra and the difference between different segments of ACDF operation. Methods: a retrospective analysis of 52 cases of ACDF operation in the First Affiliated Hospital of Nanjing Medical University from February 2013 to January 2016 The sagittal plane parameters of the cervical spine before and after the operation were measured on MRI, including C0C2 angle, C2C7 angle, T1 inclination, neck angle, and chest angle. The clinical efficacy was evaluated by the visual analogue score of the pain (visual analogue scale, VAS) and the Department of orthopedics society of Japan (Japanese Orthopaedic Association Scores). Results: the results were statistically analyzed. Results: after the operation, the C2C7 angle, T1 inclination was larger than that before the operation, the neck angle was lower than that before the operation (P0.05), and the postoperative VAS and JOA scores were significantly improved (P0.05). The single segment, double segment and multi segment operation were different in the time of operation and the amount of bleeding (P=0.001), and the difference before and after the operation of the sagittal parameter of the cervical spine. There is no significant difference between the three. Conclusion: anterior cervical discectomy and fusion are effective in the treatment of cervical spondylosis. By changing the curvature of the cervical vertebra and increasing the T1 inclination to restore the balance of the sagittal position of the cervical spine, the cervical spine surgery with different segments of the cervical vertebra has no effect on the change of the sagittal parameter of the cervical vertebra and the improvement rate of the treatment. Distinct differences.

【作者单位】：南京医科大学第一附属医院骨科;南京医科大学附属江宁医院骨科;
【基金】：国家自然科学基金(81371967) 江苏省“六大人才高峰”C类资助项目(2014-WSN-012) 江苏省第五期“333工程”培养资金项目(BRA2016512)
【分类号】：R687.3

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