人工颈椎间盘置换与颈前路减压植骨融合术治疗脊髓型颈椎病近期疗效的回顾性研究

摘要 目的：回顾性分析人工颈椎间盘置换（ADR）与颈前路减压植骨融合术（ACDF）治疗脊髓型颈椎病（CSM）的近期疗效。方法：回顾性选取2016年7月~2018年12月期间我院收治的CSM患者120例，上述患者根据手术方式的不同分为A组（n=58，ACDF治疗）和B组（n=62，ADR治疗），比较两组患者疗效、围术期指标、生活质量简表（SF-12）评分、日本矫形外科协会（JOA）评分、颈椎活动度及并发症发生情况。结果：B组术后12个月的优良率为74.19%（46/62），高于A组的53.45%（31/58）（P<0.05）。两组患者术后6个月、术后12个月躯体健康评分、精神健康评分均较术前升高，且B组高于A组（P<0.05）。B组术后1个月、术后3个月、术后6个月、术后12个月JOA评分和颈椎活动度均高于A组（P<0.05）。B组住院时间、术后颈托固定时间、术后恢复工作时间均短于A组（P<0.05）。两组术后并发症发生率比较差异无统计学意义（P>0.05）。结论：与ACDF治疗相比，ADR治疗CSM的近期疗效显著，可有效改善患者脊椎功能及生活质量，且安全性较好，临床应用价值较高。

A Retrospective Study on the Short-term Effect of Artificial Cervical Disc Replacement and Anterior Cervical Decompression and Fusion in the Treatment of Cervical Spondylotic Myelopathy

ABSTRACT Objective: To retrospectively analyze the short-term effect of artificial cervical disc replacement (ADR) and anterior cervical decompression and fusion (ACDF) in the treatment of cervical spondylotic myelopathy (CSM). Methods: A total of 120 patients with CSM in our hospital from July 2016 to December 2018 were retrospectively selected. The above patients were divided into group A (n=58, ACDF treatment) and group B (n=62, ADR treatment) according to different surgical methods. The curative effect, perioperative index, quality of life (SF-12) score, Japan Orthopaedic Association (JOA) score, cervical vertebra activity and complications happened of the two groups were compared. Results: The excellent and good rate of group B was 74.19% (46/62), which was higher than 53.45% (31/58) of group A (P<0.05). The scores of physical health and mental health of the patients of the two groups at 6 months and 12 months after operation were higher than those before operation, and those of group B were higher than those of group A (P<0.05). The JOA score and cervical vertebra activity of group B at 1 month, 3 months, 6 months and 12 months after operation were higher than that of group A (P<0.05). The hospitalization time, fixation time of cervical bracket after operation and recovery time to work after operation of group B were shorter than those of group A (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Compared with ACDF, ADR can improve the spinal function and quality of life of patients with CSM in the short term, which has better safety, and higher clinical application value.