摘要
目的探究多节段脊髓型颈椎病(MCSM)患者应用显微镜辅助下颈前路椎间盘切除减压融合术(ACDF)的治疗效果。方法选取2022年1月至2024年12月吉安市中心人民医院收治的40例MCSM(2~3节段)患者作为研究对象,按照随机数字表法分为对照组(20例)与观察组(20例)。对照组采用常规颈前路ACDF治疗,观察组采用显微镜辅助下颈前路ACDF治疗。比较两组围手术期指标、颈椎功能优良率、术后颈椎曲度指数、日本骨科协会(JOA)评分、颈椎功能障碍指数(NDI)评分、视觉模拟评分法(VAS)、矢状位参数指标及并发症发生情况。结果观察组的手术时间、住院时间短于对照组,术中出血量、术中引流量均少于对照组,观察组的颈椎功能优良率高于对照组,差异有统计学意义(P<0.05)。观察组术后颈椎曲度指数、JOA评分高于对照组,NDI评分、VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组术后T1倾斜角、胸廓入口角、C_(2~7)Cobb角均大于对照组,C_(2~7)矢状面垂直轴小于对照组,差异有统计学意义(P<0.05)。两组患者的并发症总发生率比较,差异无统计学意义(P>0.05)。结论显微镜辅助下颈前路ACDF在MCSM患者治疗中获得显著效果,颈椎功能得到有效恢复,术后颈椎优良率较高,有助于减轻肢体疼痛程度,降低术后并发症发生风险,加快康复进程,安全可靠,具有较高的临床推广应用价值。
Objective To explore the therapeutic effect of microscopically assisted anterior cervical discectomy and fusion(ACDF)in patients with multi-segmental cervical spondylotic myelopathy(MCSM).Methods A total of 40 MCSM patients(2-3 segments)admitted to Ji'an Central People's Hospital from January 2022 to December 2024 were selected as the research subjects and randomly divided into the control group(20 cases)and the observation group(20 cases)according to the random number table method.The control group was treated with conventional ACDF,while the observation group was treated with microscopically assisted ACDF.The perioperative indicators,excellent and good rate of cervical spine function,postoperative cervical curvature index,Japanese Orthopaedic Association(JOA)score,neck disability index(NDI)score,visual analogue scale(VAS),sagittal parameter indicators and the occurrence of complications were compared between the two groups.Results The operation time and hospital stay of the observation group were shorter than those of the control group,the intraoperative blood loss and intraoperative drainage volume were both less than those of the control group,the excellent and good rate of cervical spine function in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).The cervical curvature index and JOA score of the observation group after the operation were higher than those of the control group,while the NDI score and VAS score were lower than those of the control group,the differences were statistically significant(P<0.05).The postoperative T1 inclination angle thoracic opening Angle and C_(2-7) Cobb Angle in the observation group were all larger than those in the control group,and the vertical axis of the sagittal plane of C_(2-7) was smaller than that in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of complications between the two groups of patients(P>0.05).Conclusion Microscopically assisted ACDF has a significant therapeutic effect in the treatment of MCSM patients,effectively restores cervical function,has a higher excellent and good rate after surgery,helps reduce the degree of limb pain,lowers the risk of postoperative complications,and accelerates the recovery process.It is safe and reliable and has high clinical application value.
作者
张先燎
肖强
刘建建
刘飚
曾水平
邱日峰
郭文炜
ZHANG Xianliao;XIAO Qiang;LIU Jianjian;LIU Biao;ZENG Shuiping;QIU Rifeng;GUO Wenwei(Department of Orthopedics,Ji'an Central People's Hospital,Jiangxi Province,Ji'an343000,China;Department of Orthopedics,Jiangxi Provincial People's Hospital,Jiangxi Province,Nanchang 330209,China)
出处
《中国当代医药》
2025年第24期65-69,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202511259)。
关键词
多节段脊髓型颈椎病
显微镜辅助下颈前路椎间盘切除减压融合术
常规颈前路椎间盘切除减压融合术
并发症
Multi-segmental cervical spondylotic myelopathy
Microscopically assisted anterior cervical discectomy and fusion
Conventional anterior cervical discectomy and fusion
Complications
