颈前路ROI-C与后路单开门治疗多节段脊髓型颈椎病的对比Anterior cervical decompression and fusion with ROI-C cage versus posterior open door laminoplasty for multilevel cervical spondylotic myelopathy
张磊;章君鑫;刘昊;姜为民;周峰;杨惠林;何帆;刘滔;
摘要(Abstract):
[目的]比较颈椎前路减压椎间桥形融合器(ROI-C)内固定术和后路单开门术治疗多节段脊髓型颈椎病的临床疗效。[方法]分析2013~2016年在本院手术治疗的50例多节段脊髓型颈椎病患者。其中,22例行前路减压椎间桥形融合器内固定(前路组),28例行后路单开门术(后路组)。比较两组围手术期结果、临床疗效、影像学结果和并发症。[结果]两组手术时间差异无统计学意义(P>0.05);前路组术中出血量、术后住院时间小于后路组(P<0.05)。平均随访(16.96±5.35)个月,末次随访时,两组JOA评分、VAS评分较术前均显著改善(P<0.05),两组同时间点JOA评分和VAS评分差异无统计学意义(P>0.05)。两组末次随访颈椎曲度(Cobb角)较术前均无明显改变(P>0.05),组间相同时间点Cobb角差异无统计学意义(P>0.05);两组末次随访ROM较术前均明显减少(P<0.05),前路组ROM显著小于后路组(P<0.05)。在并发症方面:前路组1例吞咽困难,2例假体位置不正,1例邻近节段退变;后路组1例C5神精麻痹,1例颈痛加重,1例邻近节段退变。并发症发生率差异无统计学意义(18.18%vs. 10.71%, P>0.05)。[结论]对多节段脊髓型颈椎病,颈椎前路减压椎间桥形融合器内固定具有术中出血量少、术后住院时间短的优点,但更易发生术后颈椎活动度减少。
关键词(KeyWords): 多节段脊髓型颈椎病;前路减压椎间融合术;ROI-C;单开门椎板成形术
基金项目(Foundation): 江苏省骨外科临床医学中心资助项目(编号:ZX201106)
作者(Author): 张磊;章君鑫;刘昊;姜为民;周峰;杨惠林;何帆;刘滔;
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DOI:
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