中国全科医学2018，Vol.21Issue(11)：1300-1304,5.DOI:10.3969/j.issn.1007-9572.2017.00.159
颈椎前后路手术治疗四节段脊髓型颈椎病的疗效研究
Outcome of the Surgical Management of Four-level Cervical Spondylotic Myelopathy Using the Anterior versus Posterior Approach
詹碧水 1蒋雪生 1周国顺 1姬亚锋1
作者信息
- 1. 313008 浙江省湖州市,浙江省湖州市中心医院骨科
- 折叠
摘要
Abstract
Objective To compare the clinical outcome of anterior cervical hybrid decompression and fusion (ACHDF) vs posterior laminoplasty (LP) with titanium microplate fixation for four-level cervical spondylotic myelopathy(CSM). Methods Between January 2008 and June 2015,67 consecutive patients with four-level CSM treated in Huzhou Central Hospital were enrolled in this study and divided into 2 groups according to the surgical approach:37 patients (anterior group) underwent anterior cervical decompression using three-level plate fixation and self-locking cage hybrid fixation,30 patients (posterior group) underwent LP with titanium microplate fixation.The following factors were compared between the two groups:duration of operation,intraoperative blood loss,amount of postoperative drainage,and length of stay(LOS) ,Japanese Orthopedic Association (JOA) scores and Visual Analogue Scale for Neck Pain(VASNP) scores measured before surgery, and at 3 periods of follow-up (3,6 months after surgery,and in June 2016).And postoperative complications were also recorded.Results No significant difference existed between the two groups in the duration of operation (P>0.05).Compared with posterior group,anterior group had less intraoperative blood loss and amount of postoperative drainage,and shorter LOS (P<0.05).At each period of postoperative follow-up,the JOA scores and VASNP scores showed significant improvement in both groups(P<0.05),but the VASNP scores and cervical curvature were better in anterior group than in posterior group (P<0.05).No obvious complications of nerve and vascular were found in both groups.Conclusion Both ACHDF and LP with titanium microplate fixation provide satisfactory clinical outcomes for patients with four-level CSM.ACHDF is associated with less intraoperative lesions and better cervical curvature improvement than LP with titanium microplate fixation.The choice of surgical approach should depend on the conditions of patients and surgeon's experience,but ACHDF should be concerned priority to LP with titanium microplate fixation.关键词
颈椎病/颈椎前路融合术/椎体成形术/手术后并发症Key words
Cervical spondylosis/Anterior cervical fusion/Vertebroplasty/Postoperative complications分类
医药卫生引用本文复制引用
詹碧水,蒋雪生,周国顺,姬亚锋..颈椎前后路手术治疗四节段脊髓型颈椎病的疗效研究[J].中国全科医学,2018,21(11):1300-1304,5.
