显微镜辅助下颈前路减压植骨融合术治疗颈椎病的疗效观察
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摘要
目的探讨显微镜辅助下颈前路减压植骨融合术的近期疗效。方法选取2013-08-2016-01我科收治的拟行颈前路减压植骨融合术治疗的颈椎病患者66例,随机分为显微组和对照组,每组33例,记录两组手术时间、术中出血量、术中术后并发症情况,记录术前及末次随访JOA评分,并计算神经功能改善率。结果显微组手术时间及术中出血量明显小于对照组(P<0.05),对照组中3例患者发生手术相关并发症,而显微组无一例发生;两组术前、末次随访JOA评分及神经功能改善率方面比较无明显差异(P>0.05),各组内术后末次随访JOA评分均明显大于术前(P<0.05)。结论显微镜辅助下颈前路减压植骨融合术治疗颈椎病更加安全,能降低术中术后并发症的发生率,且疗效与传统手术方式相当,值得在临床中推广。
Objective To investigate the efficacy of anterior cervical discectomy and fusion under the microscope in the treatment of patients with cervical spondylosis. Method From October2014 to January 2016, 66 patients with cervical spondylosis who underwent anterior cervical discectomy and fusion were randomly divided into microscopic group and control group. The operation time, intraoperative blood loss and complications were recorded. The preoperative and postoperative JOA score, and the improvement rate of nerve function were assessed. Results The operation time and intraoperative blood loss in microscopic group were significantly less than those in the control group(P<0.05). There were 3 cases occurred surgical complications in control group, however, none in microscopic group. The comparison of the preoperative and postoperative JOA scores between two groups showed that there was no statistically significant difference(P>0.05),however, the postoperative JOA score was significantly higher than preoperation in two groups(P<0.05). Conclusion Compared with the traditional operation, the treatment of anterior cervical discectomy and fusion under the microscope is safer, it can significantly reduce the incidence of complications, and its efficacy is comparable to that of traditional operation, it is worthy of popularizing in clinical practice.
Objective To investigate the efficacy of anterior cervical discectomy and fusion under the microscope in the treatment of patients with cervical spondylosis. Method From October2014 to January 2016, 66 patients with cervical spondylosis who underwent anterior cervical discectomy and fusion were randomly divided into microscopic group and control group. The operation time, intraoperative blood loss and complications were recorded. The preoperative and postoperative JOA score, and the improvement rate of nerve function were assessed. Results The operation time and intraoperative blood loss in microscopic group were significantly less than those in the control group(P<0.05). There were 3 cases occurred surgical complications in control group, however, none in microscopic group. The comparison of the preoperative and postoperative JOA scores between two groups showed that there was no statistically significant difference(P>0.05),however, the postoperative JOA score was significantly higher than preoperation in two groups(P<0.05). Conclusion Compared with the traditional operation, the treatment of anterior cervical discectomy and fusion under the microscope is safer, it can significantly reduce the incidence of complications, and its efficacy is comparable to that of traditional operation, it is worthy of popularizing in clinical practice.
引文
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[6]黄吉军,杨建东,陶玉平,张亮,冯新民.显微减压联合颈椎Zero-P植入治疗颈椎病的临床疗效[J].实用骨科杂志,2015,(08):673-675.
[7]钟炯彪,李捷一.颈前路椎体次全切植骨钛板固定治疗脊髓型颈椎病疗效分析[J].中国现代医生,2013,(04):30-32.
[8] Bruneau M, Cornelius JF, George B.Multilevel oblique corpectomies:surgical indications and technique[J].Neurosurgery,2007,61(1):106-112.
[2]张勇鹏,徐全芳.手术显微镜辅助下颈前路减压融合术[J].实用医学杂志,2014,(24):4056-4057.
[3]杨红航,闵继康,袁永健,王丹,徐旭纯,徐毅.显微镜下颈前路椎间隙减压治疗老年脊髓型颈椎病[J].中国骨伤,2015,(01):36-38.
[4]肖帆,周容.显微镜直视下颈椎前路手术的护理配合[J].检验医学与临床,2014,(03):431-432.
[5]邵高升,江泽华,张学利.经显微镜下颈前路手术治疗颈椎病效果观察[J].天津医药,2014,(09):925-927.
[6]黄吉军,杨建东,陶玉平,张亮,冯新民.显微减压联合颈椎Zero-P植入治疗颈椎病的临床疗效[J].实用骨科杂志,2015,(08):673-675.
[7]钟炯彪,李捷一.颈前路椎体次全切植骨钛板固定治疗脊髓型颈椎病疗效分析[J].中国现代医生,2013,(04):30-32.
[8] Bruneau M, Cornelius JF, George B.Multilevel oblique corpectomies:surgical indications and technique[J].Neurosurgery,2007,61(1):106-112.