超高龄多节段颈椎病患者外科治疗方案的效果对比分析

发布时间：2018-07-13 10:53

【摘要】：目的探讨超高龄多节段颈椎病患者的不同外科治疗方案的效果。方法选取2010年7月至2015年3月四川省眉山市中医院收治的超高龄多节段颈椎病患者80例,将颈前路椎体次全切除融合术(ACCF)和经前路椎间盘切除植骨融合术(ACDF)纳入前路组,将颈后路椎管扩大成形术(PCL)纳入后路组,比较两组患者的临床疗效、术中术后情况及治疗前后的颈椎脊髓损伤评分(JOA评分)、颈椎功能障碍(NDI)指数、生理曲度及颈椎活动度。结果前路组43例,其中优28例(65.12%),良5例(11.63%),可7例(16.28%),差3例(6.98%),优良率为76.74%;后路组37例,其中优24例(64.86%),良3例(8.11%),可6例(16.22%),差4例(10.81%),优良率为72.97%,两组优良率比较差异无统计学意义(P0.05)。前路组手术时间明显长于后路组(P0.05),术中出血量、住院时间明显低于后路组(P0.05),两组患者的症状消失时间差异无统计学意义(P0.05)。治疗前,两组患者的JOA评分、NDI指数、生理曲度、颈椎活动度差异均无统计学意义(P0.05)。治疗后,后路组患者的JOA评分、颈椎活动度明显高于前路组,前路组患者的生理曲度明显高于后路组,差异均有统计学意义(P0.05)。结论超高龄多节段颈椎病的前路、后路手术均能取得良好的临床疗效,但后路手术在改善患者远期颈椎功能方面优势更大。
[Abstract]:Objective to investigate the effect of different surgical treatments for patients with multiple segmental cervical spondylosis. Methods 80 cases of super elderly multiple segmental cervical spondylosis were selected from July 2010 to March 2015 in Meishan Hospital of Traditional Chinese Medicine of Sichuan province. Anterior cervical subtotal resection and fusion (ACCF) and anterior intervertebral discectomy and fusion (ACDF) were included. In the road group, the posterior cervical spinal canal enlargement (PCL) was taken into the posterior group to compare the clinical efficacy of the two groups, the postoperative situation and the cervical spinal cord injury score (JOA score), the cervical spine dysfunction (NDI) index, the physiological curvature and the cervical spine activity. 43 cases were superior to the anterior group, including 28 cases (65.12%), 5 good (11.63%) and 7 (16). .28%) 3 cases (6.98%), the good rate was 76.74%, 37 cases in the posterior group, including 24 (64.86%), 3 (8.11%), 6 (16.22%), 4 (10.81%), good rate of 72.97%, and no statistical difference (P0.05). The hand operation time of the anterior group was longer than that of the posterior group (P0.05). The amount of intraoperative bleeding and the time of hospitalization were significantly lower than those in the posterior group (P0 .05), the difference of the time difference between the two groups was not statistically significant (P0.05). Before treatment, the JOA score, the NDI index, the physiological curvature and the cervical vertebra activity were not statistically significant (P0.05). After treatment, the JOA score of the posterior group was significantly higher than that in the anterior group, and the physiological curvature of the patients in the anterior group was significantly higher than that in the post group. The difference in the road group was statistically significant (P0.05). Conclusion the anterior and posterior operation of the patients with multiple cervical spondylosis can achieve good clinical efficacy, but the posterior approach has a greater advantage in the improvement of the patient's long-term cervical function.
【作者单位】：四川省眉山市中医医院骨外科;四川省人民医院骨科;
【分类号】：R687.3

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