摘要
目的探讨前后路联合手术对脊椎型颈椎病(CSM)患者脊髓功能恢复及并发症的影响。方法按随机数表法将湛江中心人民医院骨外一科于2016年6月至2018年6月期间收治的186例CSM患者分为前路组、后路组及前后路联合组,每组62例。前路组行颈椎前路椎体次全切减压植骨融合内固定术治疗,后路组行颈椎后路单开门椎管扩大成形术治疗,前后路联合组行颈椎前后路联合术治疗,术后所有患者均随访12个月,比较三组患者的脊髓功能恢复情况、颈椎功能评分、颈椎生理弧度、生活质量以及并发症发生情况。结果前后路联合组脊髓功能优良率为90.32%,明显高于前路组的74.19%和后路组的75.81%,差异有统计学意义(P<0.05);与术前比较,三组患者术后3个月、6个月及12个月时的JOA评分、颈椎D值及生活质量评分均较高,且与前路组和后路组比较,前后路联合组患者术后3个月、6个月及12个月时的JOA评分、颈椎D值均较高,差异均有统计学意义(P<0.05);前后路联合组患者的并发症发生率为1.61%,略低于前路组的6.45%和后路组的4.84%,但差异无统计学意义(P>0.05)。结论前后路联合手术治疗CSM可显著促进患者脊髓功能恢复,改善颈椎功能,同时提高患者的生活质量,且并发症少,具有临床推广价值。
Objective To investigate the effect of anterior and posterior combined surgery on spinal cord function recovery and complications in patients with cervical spondylotic myelopathy(CSM).Methods According to the random number table method,186 patients with CSM admitted to First Department of Orthopaedics,the Central People's Hospital of Zhanjiang,from June 2016 to June 2018 were divided into anterior group,posterior group,and the anterior and posterior combined group,with 62 patients in each group.The anterior group applied anterior cervical vertebral vertebral decompression and bone graft fusion and internal fixation.The posterior group was treated with posterior cervical open-door laminoplasty.The anterior and posterior combined group was treated with cervical anterior and posterior approach.All the patients were followed up for 12 months.The recovery of spinal cord function,cervical function score,cervical curvature,quality of life,and complications were compared.Results The excellent rate of spinal cord function in the anterior and posterior combined group was 90.32%,significantly higher than 74.19%in the anterior group and 75.81%in the posterior group(P<0.05).Compared with before operation,JOA score,cervical vertebra D value,and quality of life score in the three groups were significantly higher at 3 months,6 months and 12 months after operation;compared with anterior and posterior groups,the JOA score and cervical vertebra D value were significantly higher at 3 months,6 months and 12 months after operation in the anterior and posterior combined group(P<0.05).The rate of complications in the anterior and posterior combined group was 1.61%,which was slightly lower than 6.45%in the anterior group and 4.84%in the posterior group,but the difference was not statistically significant(P>0.05).Conclusion Anterior and posterior combined surgery can significantly promote the recovery of spinal cord function,improve cervical spine function,improve the quality of life of patients with CSM,and results in fewer complications,which has significant clinical promotion value.
作者
叶文明
麦伟
曹智全
方文焕
YE Wen-ming;MAI Wei;CAO Zhi-quan;FANG Wen-huan(First Department of Orthopaedics,the Central People's Hospital of Zhanjiang,Zhangjiang 524400,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第3期319-322,共4页
Hainan Medical Journal
关键词
脊椎型颈椎病
前后路联合手术
神经功能
脊髓功能
并发症
Cervical spondylosis
Anterior and posterior combined surgery
Neurological function
Spinal cord function
Complications
