脊髓型颈椎病不同手术入路的疗效比较研究(1)
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[摘要] 目的：探讨脊髓型颈椎病(CSM)应用不同手术入路的临床疗效及对脊髓功能的改善情况。方法：将100例脊髓型颈椎病患者根据手术入路的选择随机分为A组与B组，每组各50例。A组采用颈椎前路减压植骨融合术，B组采用颈椎后路单开门椎管成形术，观察两组患者的手术时间、术中及术后并发症、脊髓神经功能优良率及日本骨科学会评分(JOA)术前术后的变化。结果：两组脊髓神经功能优良率比较，差异无统计学意义(P>0.05)。两组术后JOA评分均与术前比较，差异有统计学意义(P<0.05)；且术后A组JOA评分改善明显优于B组，差异有统计学意义(P<0.05)。结论：颈椎前路减压植骨融合术、颈椎后路单开门椎管成形术治疗脊髓型颈椎均具有较好的疗效，合理选择好手术适应证，对提高CSM患者的JOA评分及优良率，减少并发症的发生至关重要。
[关键词] 脊髓型颈椎病；颈椎前路减压植骨融合术；颈椎后路单开门椎管成形术；日本骨科学会评分
[中图分类号] R681.5 [文献标识码] A [文章编号] 1673-7210(2012)01(a)-032-03
Efficacy comparative study of different surgical approaches in the treatment of cervical spinal cord
CUI Mingyu
Department of Orthopedics, Daqing Oil Field General Hospital, Heilongjiang Province, Daqing 163001, China
[Abstract] Objective: To investigate the effect of variety surgical approaches treatment in the cervical spinal cord, and to improve the spinal cord function. Methods: 100 patients with cervical spinal cord were randomly divided into group A and group B according to surgical approach, each group 50 patients. Group A was given anterior cervical decompression and fusion surgery, group B was given posterior cervical open-door laminoplasty, and two groups were observed the operative time, intraoperative and postoperative complications, excellent rate of spinal cord and nerve function sets of preoperative and postoperative JOA score changing. Results: There was no significant difference of excellent rate between the two groups (P>0.05). There was a significant difference of JOA score between the two groups after operation (P<0.05); and postoperative JOA score of group A was improved significantly than that of group B, the difference was statistically significant (P<0.05). Conclusion: Anterior cervical decompression and fusion, posterior cervical open-door laminoplasty of cervical spinal cord have better efficacy, a reasonable choice of a good surgical indications is essential to improve the good rate of JOA score, and to reduce the incidence of complications of CSM patients.
[Key words] Cervical spondylotic myelopathy; Anterior cervical decompression and fusion; Posterior cervical open-door laminoplasty; JOA score ......
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