椎间盘置换与前路减压植骨融合治疗单节段颈椎病：中期效果评价

发布时间：2018-05-11 08:13

  本文选题：颈椎病 + 前路减压植骨融合　； 参考：《新疆医科大学》2015年硕士论文

【摘要】：目的：比较前路减压植骨融合内固定与颈椎间盘置换治疗单节段颈椎病的中期疗效。方法：回顾性收集新疆医科大学第一附属医院脊柱外科2008年1月至2010年12月收治的114例单节段颈椎病患者,86例行前路减压植骨融合内固定,28例行人工颈椎间盘置换。比较两组患者手术时间、出血量、日本矫形外科协会(JOA)评分、颈部及上肢视觉模拟评分、颈椎残障功能指数(NDI)及邻近节段退变情况。根据Odom标准与JOA改善优良率评定临床疗效。结果：①两组患者末次随访时JOA评分、视觉模拟评分、NDI均较治疗前明显改善(尸0.05)。组间比较两组患者手术时间、出血量、治疗前及末次随访时JOA评分、视觉模拟评分、NDI及其差值差异无显著性意义(P0.05)。JOA优良率前路减压植骨融合组为86%,颈椎间盘置换组为89%；根据Odom标准优良率前路减压植骨融合组为83%,颈椎间盘置换组为93%,差异均无显著性意义(P0.05)。②末次随访时前路减压植骨融合组有22例手术邻近节段出现退变,其中上位节段15例,下位节段7例,22例中有3例因出现临床症状再次手术；颈椎间盘置换组有2例出现相邻节段退变,上位节段与下位节段各1例,无再次手术病例。结论：两种手术方式都能有效治疗单节段颈椎病且疗效相当；与融合相比,椎间盘置换术可降低术后相邻节段的发生率或延缓其发生前路减压植骨融合术可加速邻近节段的退变,尤其是手术节段的上位节段。
[Abstract]:Objective: To compare the medium-term efficacy of anterior decompression and fusion internal fixation and cervical disc replacement in the treatment of single segment cervical spondylosis. Methods: retrospective collection of 114 cases of single segment cervical spondylosis treated in the First Affiliated Hospital of Xinjiang Medical University from January 2008 to December 2010, 86 cases with anterior decompression, bone fusion and internal fixation, 28 cases. Artificial cervical disc replacement. Compare the operation time, the amount of bleeding, the Japanese Orthopedic Association (JOA) score, the visual simulation score of the neck and upper limbs, the cervical disability function index (NDI) and the adjacent segment degeneration. The outcome of the two groups was evaluated by the improvement of the good rate according to the Odom standard and the JOA. Results: (1) the JOA score at the last follow-up of the two groups, Visual analogue score, NDI was significantly better than before treatment (0.05). Compared with the two groups, the operation time, the amount of bleeding, the JOA score, the visual analogue score, the difference between NDI and the difference value were not significant (P0.05).JOA good rate of anterior decompression and fusion group was 86%, the cervical intervertebral disc replacement group was 89%, according to the Odom mark. The quasi fine rate anterior decompression and fusion group was 83%, and the cervical disc replacement group was 93%, the difference was not significant (P0.05). In the last follow-up, there were 22 cases of adjacent segment degeneration in anterior decompression and fusion group, of which 15 cases were the upper segment, 7 cases in the lower segment, 3 cases in 22 cases were reoperated because of clinical symptoms; cervical disc intervertebral disc was found in 22 cases. There were 2 cases of adjacent segment degeneration in the replacement group, 1 cases in the upper and lower segments and no reoperation cases. Conclusion: the two kinds of surgical methods can effectively treat the single segment cervical spondylosis and the curative effect is quite effective. Compared with the fusion, the intervertebral disc replacement can reduce the incidence of adjacent segments after the operation or delay its anterior decompression and fusion. It can accelerate the degeneration of adjacent segments, especially the upper segment of the operative segment.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
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本文编号：1873163