两种颈前路术式治疗老年患者双节段脊髓型颈椎病的疗效比较

被引：10

作者：

王华仁

陈少文

杨焱鑫

曾辉

机构：

[1] 武警广东省总队医院骨科

来源：

中国老年学杂志 | 2016年 / 36卷 / 22期

关键词：

脊髓型颈椎病; 椎体次全切除术; 椎间盘切除术;

D O I：

暂无

中图分类号：

R687.3 [骨骼手术];

学科分类号：

100220 [骨科学];

摘要：

目的对比评价颈前路椎体次全切除植骨融合术(ACCF)及颈前路双节段椎间盘切除椎间融合术(ACDF)治疗老年连续双节段受累的脊髓型颈椎病的疗效。方法选择42例老年脊髓型颈椎病患者,随机分为2组,采用ACCF治疗19例(ACCF组)和ACDF治疗23例(ACDF组),根据颈椎侧位片测量颈椎生理曲度Cobb角的变化,记录植入物下沉、移位等植入物相关的并发症发生率及植骨融合率,根据随访MRI评估手术减压效果以及JOA评分评估神经功能改善率。结果两组脊髓型颈椎病患者术后随访2年,两组患者都获得100%植骨融合率,MRI检查显示手术减压效果相当,JOA评分神经功能改善率两组无显著差异(P>0.05),而ACCF组Cobb角为(19.95±1.35)°,ACDF组Cobb角为(22.78±2.02)°,两组差异显著(P<0.05),ACCF组植入物相关的并发症发生率为21.05%明显高于ACDF组(0%,P<0.05)。结论老年连续双节段脊髓型颈椎病患者两种颈前路减压手术都可以获得满意的脊髓减压效果及神经功能恢复,最终都能够获得骨性融合,而ACDF更趋合理,优势在于更利于维持颈椎生理弧度及椎间隙高度,植入物相关的并发症发生率低,为植骨融合提供稳定的局部力学环境。

引用

页码：5668 / 5670

页数：3

共 10 条

[1]

颈前路分段减压植骨融合术治疗老年多节段脊髓型颈椎病 [J].

张国威 ;

林宏生 ;

吴昊 ;

熊廷亮 ;

纪志盛 ;

林宏生 .

中国老年学杂志, 2014, 34 (02) :291-293

[2]

Comparison of anterior cervical fusion after two-level discectomy or single-level corpectomy: sagittal alignment, cervical lordosis, graft collapse, and adjacent-level ossification [J].

Park, Yung ;

Maeda, Takeshi ;

Cho, Woojin ;

Riew, K. Daniel .

SPINE JOURNAL, 2010, 10 (03) :193-199

[3]

Two-Level Anterior Cervical Discectomy Versus One-Level Corpectomy in Cervical Spondylotic Myelopathy [J].

Oh, Min Chul ;

Zhang, Ho Yeol ;

Park, Jeong Yoon ;

Kim, Keun Su .

SPINE, 2009, 34 (07) :692-696

[4]

Two-level contiguous cervical disc disease treated with peek cages packed with demineralized bone matrix: results of 3-year follow-up [J].

Topuz, Kivanc ;

Colak, Ahmet ;

Kaya, Serdar ;

Simsek, Hakan ;

Kutlay, Murat ;

Demircan, Mehmet Nusret ;

Velioglu, Murat .

EUROPEAN SPINE JOURNAL, 2009, 18 (02) :238-243

[5]

Increased rate of arthrodesis with strut grafting after multilevel anterior cervical decompression [J].

Hilibrand, AS ;

Fye, MA ;

Emery, SE ;

Palumbo, MA ;

Bohlman, HH .

SPINE, 2002, 27 (02) :146-151

[6]

Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels [J].

Katsuura, A ;

Hukuda, S ;

Saruhashi, Y ;

Mori, K .

EUROPEAN SPINE JOURNAL, 2001, 10 (04) :320-324

[7]

Increased fusion rates with cervical plating for two-level anterior cervical discectomy and fusion [J].

Wang, JC ;

McDonough, PW ;

Endow, KK ;

Delamarter, RB .

SPINE, 2000, 25 (01) :41-45

[8]

Anterior cervical allograft arthrodesis and instrumentation: Multilevel interbody grafting or strut graft reconstruction [J].

Swank M.L. ;

Lowery G.L. ;

Bhat A.L. ;

McDonough R.F. .

European Spine Journal, 1997, 6 (2) :138-143

[9]

A MICROSURGICAL ANTERIOR OSTEOPHYTECTOMY FOR CERVICAL SPONDYLOTIC MYELOPATHY [J].

KADOYA, S ;

NAKAMURA, T ;

KWAK, R .

SPINE, 1984, 9 (05) :437-441

[10]

Cervical Spondylosis with Moderate to Severe Myelopathy: A Report of Seventeen Cases Treated by Robinson Anterior Cervical Discectomy and Fusion.[J].HENRY H. BOHLMAN.Spine.1977, 2

← 1 →