| 王海波,李欣,王子然,陈德纯,卢一生*.颈椎前路椎体可控前移融合术和颈椎前路椎体次全切除融合术治疗多节段脊髓型颈椎病伴椎管狭窄的短期疗效[J].脊柱外科杂志,2024,22(4):222-227. |
颈椎前路椎体可控前移融合术和颈椎前路椎体次全切除融合术治疗多节段脊髓型颈椎病伴椎管狭窄的短期疗效  点此下载全文 (Fulltext) |
| 王海波 李欣 王子然 陈德纯 卢一生* |
中国人民解放军联勤保障部队第903医院(全军脊柱外科治疗中心)
骨科, 杭州 310004 |
基金项目：浙江省医药卫生科技计划项目（2022KY1031）
杭州市医药卫生科技项目（B20231028） |
| DOI：10.3969/j.issn.1672-2957.2024.04.002 |
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| 摘要： |
| 目的 评估颈椎前路椎体可控前移融合术（ACAF）和颈椎前路椎体次全切除融合术（ACCF）治疗多节段脊髓型颈椎病伴椎管狭窄（MCSMSS）的临床疗效。 方法 回顾性分析2021年6月—2022年6月收治的61例MCSMSS患者临床资料，按手术方式分为ACAF组（n=28）和ACCF组（n=33）。采用日本骨科学会（JOA）评分和疼痛视觉模拟量表（VAS）评分评价临床疗效，测量手术前后C2~7 Cobb角评价颈椎曲度恢复情况，并记录术中、术后并发症发生情况。 结果 所有手术顺利完成，患者随访时间> 6个月。2组末次随访JOA评分、VAS评分及C2~7 Cobb角较术前改善，差异均有统计学意义（P < 0.05）；且ACAF组末次随访JOA评分、JOA评分改善率、VAS评分优于ACCF组，差异均有统计学意义（P < 0.05）。ACAF组术后并发症发生率为21.4%（6/28），ACCF组为36.4%（12/33），组间差异有统计学意义（P < 0.05）。末次随访时2组手术节段融合率均为100%。 结论 ACAF和ACCF治疗MCSMSS均有较好的短期临床疗效，ACAF可作为治疗MCSMSS的一种选择方案，其远期临床疗效尚须进一步研究评估。 |
| 关键词：颈椎 颈椎病 椎管狭窄 椎间盘切除术 脊柱融合术 减压术，外科 |
| Short-term efficacy of anterior controllable antedisplacement fusion and anterior cervical corpectomy and fusion in treatment of multilevel cervical spondylotic myelopathy with spinal stenosis Fulltext |
| Wang Haibo Li Xin Wang Ziran Chen Dechun Lu Yisheng* |
| Department of Orthopaedics, Whole Army Spinal Surgery Treatment Center, No. 903 Hospital of Joint Logistics Support Force of Chinese PLA, Hangzhou 310004, Zhejiang, China |
| Fund Project: |
| Abstract: |
| Objective To evaluate the short-term clinical efficacy of anterior controllable antedisplacement fusion（ACAF） and anterior cervical corpectomy and fusion（ACCF） in the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis（MCSMSS）. Methods A retrospective analysis was conducted on the data of 61 MCSMSS patients from June 2021 to June 2022. They were divided into ACAF group（n=28） and ACCF group（n=33） according to surgical methods. The clinical efficacy was evaluated using the Japanese Orthopaedic Association（JOA） score and pain visual analogue scale（VAS） score. The C2~7 Cobb angle before and after surgery was measured to evaluate the recovery of cervical curvature. Intraoperative and postoperative complications were recorded. Results All the operations were successfully completed，and the patients were followed up for more than 6 months. The JOA score，VAS score and C2~7 Cobb angle of the 2 groups improved at the final follow-up compared to pre-operation，and the differences were statistically significant（P < 0.05）. At the final follow-up，the JOA score，improvement rate of JOA score and VAS score of the ACAF group were better than those of the ACCF group，and the differences were statistically significant（P < 0.05）. The incidence of postoperative complications in the ACAF group was 21.4%（6/28），and 36.4%（12/33） in the ACCF group，and the difference was statistically significant（P < 0.05）. At the final follow-up，the fusion rate of surgical segments in both groups was 100%. Conclusion sBoth ACAF and ACCF have good short-term clinical efficacy in the treatment of MCSMSS. ACAF can be used as an alternative treatment for MCSMSS，but its long-term clinical efficacy still needs further research and evaluation. |
| Keywords:Cervical vertebrae Cervical spondylosis Spinal stenosis Diskectomy Spinal fusion Decompression,surgical |
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