前路椎间盘减压融合与前路椎体次全切除减压融合治疗多节段颈椎病的疗效比较

目的:探索前路椎间盘减压融合与前路椎体次全切除减压治疗多节段颈椎病的疗效,为临床手术方式的选择提供依据。方法:收集我院骨科2008年6月到2014年6月收治的多节段颈椎病患者26例,按照患者手术方式分为研究组(13例)和对照组(13例),研究组给予前路椎间盘减压融合治疗,对照组给予前路椎体次全切除减压治疗,对比两组手术时间、术中出血量、术后住院时间,记录并分析两组术前和术后3月、6月、12个月JOA评分、颈椎总活动度、颈椎曲度、颈椎节段高度。结果:研究组手术时间、术中出血量低于对照组(P0.05);两组JOA评分术前、术后3月、6月、12个月逐渐升高(P0.05),术后12月组间差异有统计学意义(P0.05)。两组颈椎总活动度术前、术后3月、6月、12个月逐渐降低(P0.05),但是术后同时期组间差异无统计学意义(P0.05)。两组颈椎曲度与颈椎节段高度术后3月、6月、12个月差异有统计学意义(P0.05)。结论:前路椎间盘减压融合治疗多节段颈椎病较前路椎体次全切除减压治疗效果好,手术时间短、术中出血量少,并且颈椎曲度和节段高度恢复好。

Comparison of Anterior Cervical Discectomy and Fusion and AnteriorCervical Corpectomy and Fusion for Multilevel Cervical Myelopathy

Objective:To explore the effect of anterior cervical discectomy and fusion and anterior cervical corpectomy and fusionin the treatment of multilevel cervical myelopathy, and to provide the basis for the clinical operation mode.Methods:A total of 26patients with multilevel cervical myelopathy, who were treated in First Hospital of Fangshan District from June 2008 to June 2014, wereselected and divided into study group (n=13) and control group (n=13) according to the operation mode. The study group underwentanterior cervical discectomy and fusion, while the control group underwent anterior cervical corpectomy and fusion. The operation time,intraoperative blood loss, postoperative hospitalization time were compared between the two groups; The JOA scores, cervical range ofmotion, cervical curvature and the height of cervical spine of the two groups were recorded and analyzed before operation and 3 months,6 months, 12 months after operation.Results:The operation time and intraoperative blood loss of the study group were less than those ofthe control group (P<0.05). JOA scores of the two groups gradually increased before operation and 3 months, 6 months, 12 months afteroperation(P<0.05), there were statistically significant differences 12 months after operation between the two groups(P<0.05). The cervicalrange of motion of the two groups gradually decreased before operation and 3 months, 6 months, 12 months after operation(P<0.05) (P<0.05), without significant differences between the two groups (P>0.05). There were significantly statistical differences in the cervicalcurvature and the height of cervical spine 3 months, 6 months, 12 months after operation between the two groups (P<0.05).Conclusion:Anterior cervical discectomy and fusion has a better effect than anterior cervical corpectomy and fusion in the treatment of patients withmultilevel cervical myelopathy, with the advantages of shorter operation time, less intraoperative blood loss, and better improvement ofcervical curvature and the height of cervical spine.