摘要
目的探讨颈椎前路减压融合术对多节段脊髓型颈椎病患者颈椎矢状位平衡参数及颈椎功能的影响,为相关疾病的治疗提供理论依据。方法选取2018年3月—2020年6月开封市中心医院骨科收治的86例多节段脊髓型颈椎病患者为研究对象,依据随机数表法分为对照组(n=43)与观察组(n=43)。观察组行颈椎前路减压融合术,对照组患者行后路单开门椎管成形术。分析并比较两组临床指标、疼痛程度、颈椎功能、颈椎矢状位参数、神经功能及并发症情况。结果观察组的手术时间、住院时间均明显短于对照组(127.36±13.83)min vs(206.85±17.29)min;(9.15±1.62)d vs(10.07±1.66)d,P<0.05,两组在术中失血量方面无明显差异(P>0.05);治疗后两组VAS评分明显下降,且观察组下降幅度更大(P<0.05),两组NDI指数无明显差异(P>0.05);两组Cobb角、T1倾斜角、颈椎整体活动度(ROM)无明显差异(P>0.05);治疗后观察组JOA评分明显高于对照组,差异具有统计学意义(P<0.05);观察组出现2例(4.65%)并发症,对照组出现3例(6.98%)并发症,两组并发症发病率无明显差异(P>0.05)。结论颈椎前路减压融合术能够有效改善多节段脊髓型颈椎病颈前路手术患者颈椎矢状位平衡参数,促进患者术后颈椎功能的恢复,临床疗效良好,是一种安全、有效的治疗方式。
Objective To investigate the effect of anterior cervical decompression and fusion on cervical sagittal balance parameters and cervical function in patients with multi-level cervical spondylotic myelopathy.To provide theoretical basis for the treatment of related diseases.Methods Totally 86 patients with multi-level cervical spondylotic myelopathy admitted to the Department of orthopaedics of our hospital from March 2018 to June 2020 were selected as the study objects,and were divided into control group(n=43)and observation group(n=43)according to the random number table method.The observation group underwent anterior decompression and fusion of cervical vertebrae,and the control group underwent posterior single door laminoplasty.The clinical indexes,pain degree,cervical function,cervical sagittal parameters,neurological function and complications of the two groups were analyzed and compared.Results The operation time and the hospitalization time of the two groups were significantly shorter than those the control group[(127.36±13.83)min vs(206.85±17.29)min;(9.15±1.62)d vs(10.07±1.66)d,P<0.05].There was no significant difference between the two groups in blood loss during operation(P>0.05).After treatment,the VAS score of the two groups decreased significantly,and the observation group got larger declination(P<0.05).There was no significant difference in NDI index between the two groups(P>0.05).Cobb angle,T1 inclination angle,and overall cervical mobility(ROM)of the two groups were no significant difference(P>0.05);After treatment,the JOA score of the observation group was significantly higher than that of the control group(P<0.05);There were 2(4.65%)complications in the observation group and 3(6.98%)complications in the control group.There was no significant difference in the incidence rate of complications between the two groups(P>0.05).Conclusion Anterior decompression and fusion of cervical spine can effectively improve the sagittal balance parameters of cervical spine in patients with multi-level cervical spondylotic myelopathy,and promote the recovery of cervical spine function after operation.It has a good clinical effect and is a safe and effective treatment.
作者
赵浩增
郭永传
贾思明
马守战
ZHAO Hao-zeng;GUO Yong-chuan;JIA Si-ming;MA Shou-zhan(Department of Orthopedics,Kaifeng Central Hospital,Kaifeng,Henan 475000,China)
出处
《医药论坛杂志》
2023年第8期39-42,47,共5页
Journal of Medical Forum
关键词
脊髓型颈椎病
前路减压融合术
矢状位参数
功能
Cervical spondylotic myelopathy
Anterior decompression and fusion
Sagittal parameters
Function
