椎体次全切时两种开槽宽度对脊髓型颈椎病的近期疗效分析

发布时间：2018-11-21 11:12

【摘要】：[目的]探讨分析颈椎前路椎体次全切植骨融合内固定术(ACCF)时使用两种不同开槽减压宽度对脊髓型颈椎病的近期治疗效果。[方法]回归性分析2012年12月~2015年1月在本院行ACCF手术的66例患者的临床效果。其中椎体次全切时采用1.4 cm开槽减压宽度治疗脊髓型颈椎病31例(1.4 cm组),在椎体次全切时采用1.0cm开槽减压宽度治疗脊髓型颈椎病35例(1.0 cm组)。将手术时间、失血量、融合节段前突角(SL)、手术并发症、术前及术后6个月JOA评分、椎体融合率进行统计学分析。[结果]所有患者随访3年。1.4 cm组手术并发症发生率为3.2%,1.0 cm组手术并发症发生率为5.7%,手术并发症发生率两组差异无统计学意义(P=1.000)。尽管1.4cm组和1.0 cm组患者术前JOA评分差异无统计学意义(P=0.858),但术后6个月1.4 cm组患者平均JOA评分显著高于1.0 cm组患者(P=0.01)。1.4 cm组平均失血量和手术时间显著高于1.0 cm组(P0.01)。根据影像学评估,1.4 cm组术后融合节段前凸角改善显著高于1.0 cm组(P0.01)。两组患者术后第12周融合率差异无统计学意义(P=0.294)。[结论]ACCF手术时,开槽减压宽度为1.4cm在神经功能恢复、融合节段前凸角比开槽减压宽度为1.0cm有更好的改善,但手术时间延长和失血量增加。
[Abstract]:[objective] to investigate the effect of two different widths of slotted decompression on cervical Spondylotic myelopathy (CSM) treated by anterior subtotal vertebra fusion and internal fixation (ACCF). [methods] the clinical results of 66 patients undergoing ACCF operation in our hospital from December 2012 to January 2015 were retrospectively analyzed. Among them, 31 cases of cervical Spondylotic myelopathy were treated with 1.4 cm slotted decompression width during subtotal vertebral body resection (1.4 cm group) and 35 cases with cervical Spondylotic myelopathy were treated with 1.0cm slotted width during subtotal vertebral body resection (1.0 cm group). The operative time, blood loss, (SL), complications, preoperative and postoperative JOA scores and fusion rate were analyzed statistically. [results] all the patients were followed up for 3 years. The incidence of operative complications in 1.4 cm group was 3.2and 1.0 cm. The incidence of operative complications was 5.7, and there was no significant difference between the two groups (P < 1.000). Although there was no significant difference in preoperative JOA score between 1.4cm group and 1.0 cm group (P0. 858), However, the mean JOA score in 1.4 cm group was significantly higher than that in 1.0 cm group at 6 months after operation (P0.01), and the mean blood loss and operative time in 1.4 cm group were significantly higher than that in 1.0 cm group (P0.01). According to the imaging evaluation, 1. 4 cm group had significantly higher improvement of fusion segmental kyphoid angle than 1. 0 cm group (P0. 01). There was no significant difference in the fusion rate between the two groups at the 12th week after operation (P < 0. 294). [conclusion] during ACCF operation, the slotted decompression width of 1.4cm is better than the slotted decompression width of 1.0cm in the recovery of nerve function, but the operation time is prolonged and the amount of blood loss is increased.
【作者单位】：安徽省马鞍山市人民医院骨科;
【分类号】：R687.3

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