| 吴信波,范国鑫,虞舜志,张海龙,顾昕,胡安南,胡硕,管晓菲,贺石生.显微镜辅助下颈前路椎间盘切除植骨融合术治疗多节段脊髓型颈椎病[J].脊柱外科杂志,2015,13(5):267-271. |
显微镜辅助下颈前路椎间盘切除植骨融合术治疗多节段脊髓型颈椎病  点此下载全文 (Fulltext) |
| 吴信波 范国鑫 虞舜志 张海龙 顾昕 胡安南 胡硕 管晓菲 贺石生 |
| 200072 上海, 同济大学医学院附属第十人民医院骨科 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2015.05.003 |
| 摘要点击次数: 1491 |
| 全文下载次数: 867 |
| 摘要： |
| 目的 探讨显微镜辅助下颈前路椎间盘切除植骨融合术(anterior cervical discectomy with fusion, ACDF)治疗多节段脊髓型颈椎病的疗效. 方法 回顾性分析2011年1月~2012年8月本院行颈前路手术治疗的60例脊髓型颈椎病患者的临床资料,根据手术方式分为常规ACDF组(A组,30例)和显微镜辅助ACDF组(B组,30例).比较2组的手术时间、术中出血量、住院天数及并发症,以日本骨科学会(Japanese Orthopaedic Association,JOA)评分(17分法)及其改善率评价术后神经功能改善情况. 结果 A组手术时间为(132.5±8.9) min,B组为(137.0±9.1) min,差异无统计学意义(P >0.05).A组术中出血量为(113.6±8.0) mL,B组为(93.7±5.3) mL,差异有统计学意义(P <0.01).A组住院(7.37±1.73) d,B组(6.63±1.13) d,差异无统计学意义(P >0.05).A组术前JOA评分为6.60±1.21,术后12个月为13.83±0.91,改善率为(69.72±7.66)%;B组术前JOA评分为6.87±1.46,术后12个月为14.23±1.17,改善率为(72.51±11.26)%.A组和B组改善率差异有统计学意义(P <0.05). 结论 显微镜辅助ACDF和常规ACDF是治疗多节段脊髓型颈椎病有效的方法,但显微镜辅助ACDF可减少术中出血量,是治疗多节段脊髓型颈椎病优先选择的手术方案. |
| 关键词：颈椎 颈椎病 椎间盘切除术 骨移植 脊柱融合术 外科手术,微创性 显微镜检查 |
| Microscope-assisted anterior cervical discectomy with fusion in treatment of multi-segmental cervical spondylotic myelopathy Fulltext |
| WU Xin-bo FAN Guo-xin YV Shun-zhi ZHANG Hai-long GU Xin HU An-nan HU Shuo GUAN Xiao-fei HE Shi-sheng |
| Department of Orthopaedic, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China |
| Fund Project: |
| Abstract: |
| Objective To investigate the curative effect of microscope-guided anterior cervical discectomy with fusion(ACDF) in treatment of multi-segmental cervical myelopathy. Methods A retrospective study was conducted on 60 patients who underwent cervical surgery from January 2011 to August 2012. Patients were divided into 2 groups:a total of 30 cases in Group A(18 with 2 segments and 12 with 3 segments) underwent standard ACDF; other 30 cases in Group B(20 with 2 segments and 10 with 3 segments) underwent microscope-assisted ACDF. Data were collected and compared in operation time, blood loss, hospital stay and complications. Japanese Orthopaedic Association(JOA) score and its improvement rate were used to evaluate neurologic function after operation. Results There was no significant difference in operation time between Group A(132.5±8.9) min and Group B(137.0±9.1) min(P >0.05). Similarly, no significant difference was observed in hospital stay between Group A(7.37±1.73) d and Group B(6.63±1.13) d(P >0.05). However, there was significant difference in blood loss between Group A(113.6±8.04) mL and Group B(93.7±5.3) mL(P <0.01). JOA score in Group A was 6.60±1.21 before operation, and 13.83±0.91 12 months after operation. The improvement rate was(69.72±7.66)% for Group A. JOA score in Group B was 6.87±1.46 before operation and 14.23±1.16 12 months after operation. The improvement rate was(72.51±11.26)% for Group B. Significant difference in improvement rate between Group A and Group B was observed(P <0.05). Conclusion Similar to standard ACDF, microscope-assisted ACDF is an effective way to treat multi-segmental cervical myelopathy. Microscope-assisted ACDF may be a prior choice since it can significantly reduce blood loss in operation with fewer complications. |
| Keywords:Cervical vertebrae Cervical spondylosis Diskectomy Bone transplantation Spinal fusion Surgical procedures, minimally invasive Microscopy |
|
|
HTML
查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
|
|
