青年人颈椎病的临床特点及前路手术疗效观察

发布时间：2018-08-04 16:31

【摘要】：[目的]探讨青年人颈椎病的临床特点及颈前路手术效果。[方法]回顾性研究2006年1月~2015年7月在本院进行颈前路椎间盘切除椎间植骨融合(ACDF)及颈椎体次全切除椎间植骨融合(ACCF)手术治疗的48例年龄≤35岁的颈椎病患者,男28例,女20例,平均年龄(32.23±4.13)岁。结合病史及影像学资料,分析该类患者的临床特点,通过比较术前、术后X线片Cobb’s角及颈椎弓深变化,以及颈椎JOA评分、VAS评分来评估前路手术治疗效果。[结果]48例患者中,30岁以上37例,长期伏案工作者(每d5 h)25例,工人农民等重体力劳动者12例,7例曾有过颈部外伤。平均病程(5.53±7.39)个月,平均随访(3.44±2.96)年,无失访患者。脊髓型28例,神经根型17例,混合型3例,共累及87个病变节段,其中C5、6节段最多,为34个。ACDF组及ACCF组分别为13例和35例。脊髓型患者神经功能由术前的平均(10.35±1.96)分提高至(15.41±1.41)分,平均改善率为(77.8±17.3)%;神经根型患者平均VAS评分由术前的(7.61±1.12)分降低为(0.64±0.61)分,Cobb's角由-15.3~23.1°恢复到-2.6~26.1°,改善了(9.25±4.52)°,颈椎弓深由(-10.1~9.1)mm恢复到(-3.5~10.7)mm,改善了(6.64±3.40)mm。两种前路手术方式对神经功能恢复、弧度恢复及弓深恢复无影响,ACCF组术中失血量大,颈椎弓深改变与Cobb's角改变有显著关系。[结论]青年颈椎病多发于长时间伏案工作或重体力劳动人群,30岁以后明显高发,主要病理改变为颈椎生理弧度的消失,颈前路手术可有效缓解疼痛,改善神经功能、纠正颈椎生理曲度,除失血量外,两种前路手术方式对结果无明显影响。
[Abstract]:[Objective] to investigate the clinical characteristics of cervical spondylosis in young people and the effect of anterior cervical surgery. [Methods] a retrospective study was conducted in 48 cases of cervical spondylosis with age less than 35 years old, 28 males and 20 women, in July, ~2015, January 2006, which were treated by anterior cervical discectomy and interbody fusion (ACDF) and cervical spinal subtotal resection of intervertebral fusion (ACCF). The average age (32.23 + 4.13) years old. Combined with the medical history and imaging data, the clinical characteristics of the patients were analyzed. The preoperative, postoperative X-ray Cobb 's angle and the depth of the cervical arch, and the JOA score of the cervical vertebra, and the VAS score were used to evaluate the effect of the anterior approach. [results among the patients with]48, 37 cases above 30 years old and 25 of the long-term volt workers (each D5 h) 25) For example, 12 cases of heavy manual labourers such as workers and peasants, 7 cases of cervical trauma. The average course of disease (5.53 + 7.39) months, average follow-up (3.44 + 2.96) years, no missing patients. 28 cases of spinal cord, 17 cases of nerve root type, 3 cases of mixed type, involving 87 segment of C5,6 segment, among which 34 group and ACCF group are 13 cases and 35 cases respectively. The neurological function of the patients was increased to (15.41 + 1.41) points (15.41 + 1.41), and the average improvement rate was (77.8 + 17.3)%. The average VAS score of the patients with nerve root type decreased from (7.61 + 1.12) to (0.64 + 0.61), and the Cobb's angle was recovered from -15.3~23.1 to -2.6~26.1 degrees, improved (9.25 + 4.52) degrees, and the depth of the cervical spine was recovered from (-10.1~9.1) mm. To (-3.5~10.7) mm, the improvement of (6.64 + 3.40) mm. two kinds of anterior surgical methods had no effect on the recovery of nerve function, the restoration of radian and the restoration of the depth of the arch. There was a significant relationship between the amount of blood loss in the group ACCF and the change of the depth of the cervical spine with the change of Cobb's angle. [Conclusion] the young cervical spondylosis is mostly in the long time of the case of the case of the case or the heavy manual labor, and the obvious after 30 years of age. The main pathological changes are the disappearance of the physiological radian of the cervical spine. The anterior cervical surgery can effectively relieve the pain, improve the function of the nerve and correct the physiological curvature of the cervical vertebra. In addition to the amount of blood loss, the results of the two anterior surgical procedures have no obvious effect on the results.
【作者单位】：南京医科大学第一附属医院骨科;
【基金】：国家自然科学基金项目(编号:81371967) 江苏省“六大人才高峰”C类资助项目(编号:2014-WSN-012)
【分类号】：R687.3

【相似文献】