一期前后路联合手术治疗前后受压型多节段脊髓型颈椎病的疗效分析
发布时间：2019-06-26 11:59
【摘要】：目的 分析探讨一期前后路联合手术(Combined anterior-posterior surgery, CAPS)治疗前后受压型多节段脊髓型颈椎病(Multilevel cervical spondylotic myelopathy, MCSM)的临床疗效、影像学效果及手术适应症。方法回顾性分析2010年1月至2014年1月我院采用一期前后路联合手术治疗的前后受压型多节段脊髓型颈椎病53例病例资料。从临床和影像学效果对手术疗效进行分析,观察住院时间、手术时间、术中出血量、日本骨科协会颈椎病评分(Japanese orthopedic association scores, JOA)、颈椎功能障碍指数(The neck disability index, NDI)、颈椎总活动度(Cervical range of motion, CROM)、颈椎曲度指数(Cervical curvature index, CCI)及手术并发症发生率,结合国内外学者的研究成果,分析探讨一期前后路联合手术治疗前后受压型多节段脊髓型颈椎病的手术疗效和适应症。结果53例患者手术顺利,2例患者随访时间不足1年而失访,剩余51例中男性33例,女性18例,年龄为42-71岁,随访时间为12-36个月。平均住院时间为(16.18±3.49)天,平均手术时间(222.55±36.23)min,平均术中出血量(506.78±136.56)ml。术前JOA评分平均为(8.51±1.57)分,术后平均为(13.67±1.70)分,术后JOA评分提高显著(P0.05),平均JOA改善率为(62.48±13.83)%；术前NDI评分平均为(38.10±4.14)分,术后平均为(21.39±3.97)分,术后NDI评分较术前降低(P0.05),NDI评分平均改善值为(16.65±3.70)分。术前CCI平均为(11.30±1.68)%,术后平均为(15.92±1.43)%,术后CCI提高(P0.05)；术前矢状面CROM平均为(75.63±8.55)。,术后平均为(50.69±5.76)。,术后CROM减少(P0.05),术后CROM平均丢失(26.35±5.56)°。术后2例患者出现脑脊液漏,6例C5神经麻痹,2例切口愈合不佳,8例吞咽疼痛,1例喉返神经损伤,前方植骨均愈合良好,后方无再关门发生。结论一期前后路联合手术治疗前后受压型多节段脊髓型颈椎病具有减压充分、术后神经功能改善和颈椎稳定好的优势,是一种较好的手术方式,但需要考虑其手术创伤大、术后颈椎活动度丢失及并发症较多的不足,需严格把握适应症。
[Abstract]:Objective to analyze the clinical efficacy, imaging effect and surgical indication of compression multisegmental cervical Spondylotic myelopathy (Multilevel cervical spondylotic myelopathy, MCSM) before and after one-stage anterior and posterior combined surgery (Combined anterior-posterior surgery, CAPS). Methods from January 2010 to January 2014, 53 cases of compression multisegmental cervical Spondylotic myelopathy were treated with one stage anterior and posterior combined surgery. The curative effect of operation was analyzed from clinical and imaging results, and the hospitalization time, operation time, intraoperative blood loss, cervical spondylosis score (Japanese orthopedic association scores, JOA), cervical dysfunction index (The neck disability index, NDI), cervical curvature index (Cervical curvature index, CCI) and the incidence of surgical complications were observed, combined with the research results of scholars at home and abroad. To analyze the curative effect and indication of compression multisegmental cervical Spondylotic myelopathy before and after one stage anterior and posterior combined surgery. Results the operation was smooth in 53 patients. The follow-up time of 2 patients was less than 1 year. The remaining 51 patients were 33 males and 18 females, aged 42 鈮，
本文编号：2506164
[Abstract]:Objective to analyze the clinical efficacy, imaging effect and surgical indication of compression multisegmental cervical Spondylotic myelopathy (Multilevel cervical spondylotic myelopathy, MCSM) before and after one-stage anterior and posterior combined surgery (Combined anterior-posterior surgery, CAPS). Methods from January 2010 to January 2014, 53 cases of compression multisegmental cervical Spondylotic myelopathy were treated with one stage anterior and posterior combined surgery. The curative effect of operation was analyzed from clinical and imaging results, and the hospitalization time, operation time, intraoperative blood loss, cervical spondylosis score (Japanese orthopedic association scores, JOA), cervical dysfunction index (The neck disability index, NDI), cervical curvature index (Cervical curvature index, CCI) and the incidence of surgical complications were observed, combined with the research results of scholars at home and abroad. To analyze the curative effect and indication of compression multisegmental cervical Spondylotic myelopathy before and after one stage anterior and posterior combined surgery. Results the operation was smooth in 53 patients. The follow-up time of 2 patients was less than 1 year. The remaining 51 patients were 33 males and 18 females, aged 42 鈮，
本文编号：2506164
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