颈椎前路融合术后相邻节段退变对远期疗效的影响

The long-term effect of anterior cervical fusion surgery for adjacent segment degeneration

目的探讨颈椎前路节段性融合术后相邻节段退变对远期疗效的影响。方法观察颈椎前路融合术后其相邻节段的退变情况,生理曲度变化情况、颈椎失稳程度等,并根据退变情况加以分型。结果所有患者获得随访(5.7±1.4)年,其相邻节段退变发生率为63.6%。随访病例中由于相邻节段退变较重再行后路单开门椎管扩大成形手术的比例约21.2%,相邻节段退变与手术患者的年龄、手术前相邻节段间盘的退变情况、融合节段的长短、颈椎生理曲度的大小、术后康复指导、工作性质等有直接关系。结论相邻节段退变是颈椎前路节段性融合手术主要的远期并发症,严格的手术前评估、手术节段的准确、术后的康复指导是减缓相邻节段退变的有效方法。

Objective To investigate the long - term effect of segmental anterior cervical fusion surgery for adjacent segment degeneration. Methods The degeneration was classified according to the physiological changes of curvature, the degree of cervical spine instability after anterior cervical fusion of the adjacent segment degeneration. Results All patients were followed - up for 5.7 ± 1.4 years, and its adjacent segment degeneration rate was 63.6%. The ratio of cases with heavier adjacent segment degeneration underwent posterior single door laminoplasty surgery was about 21.2%. The adjacent segment degeneration had a direct relationship with surgical patient＇s age, pre - operative disc degeneration between adjacent segments, fusion segments of length, the size of cervical lordosis, postoperative rehabilitation guidance and the nature of work. Conclusion Adjacent segment degeneration from anterior cervical fusion was major, long - term surgery complications. The effective way for slowing degeneration of adjacent segments was st/ict pre - operative evaluation, accurate surgery and postoperative rehabilitation.