摘要
目的探讨颈椎椎间盘完全置换术(cervical-total disc replacement,c-TDR)与前路颈椎椎间盘切除融合术(anterior cevical discectomy and fusion,ACDF)对连续双节段颈椎病患者的疗效。方法选取2014-04-2015-04收治的连续双节段颈椎病患者70例,依据手术方式分为研究组(n=36,接受c-TDR术)、对照组(n=34,接受ACDF术),对比两组手术基本情况、影像学指标[手术前后颈椎曲度、颈椎总活动度(ROM)及相邻节段骨化分级]、颈椎功能障碍指数(NDI)、并发症。结果研究组手术时间较对照组明显延长,但研究组术后3 d疼痛评分显著低于对照组(P<0.05);研究组术后6个月、2年颈椎曲度、ROM均显著高于对照组,NDI指数显著低于对照组(P<0.05);研究组术后2年相邻节段骨化分级显著低于对照组(P<0.05),两组术后2年并发症发生率无统计学差异(P>0.05)。结论 c-TDR术与ACDF术相比,治疗连续双节段颈椎病疗效较好,虽然手术时间长,但可有效维持颈椎生理曲度及颈椎活动度,减少相邻节段骨化及颈椎功能障碍。
Objective To explore the efficacy of cervical total disc replacement （c -TDR） andanterior cervical discectomy and fusion （ACDF） in the treatment of patients with continuous two-levelcervical spondylosis. Methods From April 2014 to April 2015, 70 patients with continuous two-levelcervical spondylosis were divided into the study group （n=36, given c-TDR） and the control group （n=34, given ACDF）. The basic operation conditions, imaging indicators [cervical curvature, total range ofmotion （ROM） and adjacent level ossification grade], neck disability index （NDI） and complicationswere compared between the two groups. Results The operation time of the study group was longerthan that of the control group, but the pain score of the study group was significantly lower than that ofthe control group on the 3rd day after operation （P〈0.05）. The cervical curvature and ROM of thestudy group were significantly higher than those of the control group at 6 months and 2 years afteroperation, and the NDI index was significantly lower than that of the control group （P 〈0.05）. Theossification grade of adjacent segments in the study group was significantly lower than that of thecontrol group （P〈0.05）. There was no significant difference in the incidence of complications betweenthe two groups after 2 years （P〉0.05）. Conclusions Compared with ACDF, c-TDR has better efficacyin the treatment of continuous two -level cervical spondylosis. Although c -TDR has long operativetime, it can effectively maintain the cervical physiological curvature and range of motion, and reducethe adjacent level ossification and cervical dysfunction.
作者
殷铁林
王祥善
梅伟
YIN Tie-lin;WANG Xiang-shan;MEI Wei(Orthopaedic Hospital of Zhengzhou,Zhengzhou,Henan,450052,China)
出处
《颈腰痛杂志》
2018年第6期738-741,共4页
The Journal of Cervicodynia and Lumbodynia
