摘要
目的探讨颈前路手术治疗脊髓型颈椎病的临床效果及影响因素.方法选取临汾市人民医院2012年1月至2016年12月收治的脊髓型颈椎病患者200例,均采用颈前路手术方案治疗,观察术前及术后6个月脊髓功能,即Nurick分级、JOA评分,并依据JOA评分情况,评估手术疗效,同时根据JOA优良率,以单因素作自变量(Logistic回归方程),分析疗效的独立影响因素.结果术后6个月,200例患者Nurick分级低于术前,JOA评分高于术前,差异有统计学意义(P<0.05).200例患者中疗效优80例,良102例,手术优良率为91%(182/200).颈髓MRI信号改变、病程、外伤是疗效的独立危险因素(P=0.027、0.023、0.004).结论脊髓型颈椎病患者应用颈前路手术治疗,可有效改善脊髓功能,但要注意防范病程、外伤、颈髓MRI信号改变对疗效的影响,以全面保障手术质量,改善患者预后.
Objective To investigate the clinical effect and influencing factors of anterior cervical surgery for cervical spondylotic myelopathy.Methods A total of 200 patients with cervical spondylotic myelopathy who were admitted to Linfen People’s Hospital from January 2012 to December 2016 were treated with anterior cervical approach.The spinal cord function was observed before and 6 months after operation,such as nurick classification,JOA score.And based on the JOA score,the efficacy of surgery was evaluated.At the same time,according to the excellent rate of JOA,the independent influence factors of the curative effect were analyzed by single factor independent variable(Logistic regression equation).Results The average nurick score of 200 patients was lower than that of preoperative,and the JOA score was higher than that before surgery 6 months after surgery(P<0.05).Among the 200 patients,the curative effect was excellent in 80 cases and good in 102 cases.The excellent and good rate of operation was 91%(182/200).MRI signal changes,duration of disease,and trauma were the independent risk factors for efficacy(P=0.027,0.023,0.004).Conclusions The treatment of cervical spondylotic myelopathy with anterior cervical approach can effectively improve the function of the spinal cord,but the impact of disease course,trauma and cervical MRI signal on the curative effect should be paid attention,so as to comprehensively guarantee the quality of surgery and improve the prognosis of patients.
作者
赵昱
Zhao Yu(Linfen People's Hospital,Linfen Hospital Affiliated to Shanxi Medical University ( the Seventh Clinical Medical College),Linfen 041000,China)
出处
《中国实用医刊》
2019年第14期77-79,共3页
Chinese Journal of Practical Medicine
关键词
颈椎病
脊髓型
颈前路手术
MRI信号
Cervical spondylosis,Spinal cord type
Anterior cervical surgery
MRI signal
