两种不同手术方式治疗多节段颈椎病初期疗效比较

Primary effects comparison of two different surgical approach in the treatment of cervical myelopathy

目的分析颈前路椎间盘切除减压植骨融合术(ACDF)和颈后路椎板成形术(PCL)治疗多节段颈椎病的初期临床疗效。方法行ACDF的18例多节段颈椎病患者被设为A组;行PCL术的15例为B组。分别比较两组术前、术后18个月的日本矫形外科协会(JOA)评分、颈椎残障功能指数(NDI)、颈椎活动度(ROM)、视觉模拟疼痛评分(VAS)等指标,以及并发症情况。结果两组患者术前、术后18个月JOA评分、NDI、ROM比较差异均具有统计学意义(P<0.05)。术后12及18个月两组患者VAS比较差异有统计学意义(P<0.05)。B组并发症发生率(7%)低于A组(39%)(P<0.05)。结论 PCL治疗多节段颈椎病的初期临床疗效较好,但随访病例数较少,仍需收集多病例、长期随访,严格的评估其有效性和安全性。

Objective To explore the initial clinical curative effects of anterior cervical diskectomy decompression and fusion （ACDF） and posterior cervical laminoplasty （PCL） in multi-segmental cervical spondylotic myelopathy. Methods ACDF was performed in 18 cases （group A）, PCL was performed in 15 patients （ group B）. Evaluation of preoperative patients respectively, at the end of the follow-up of Japanese or- thopaedic association （JOA）, neck disability index （NDI）, range of motion （ROM）, visual analogue scale （VAS）. Results JOA score, NDI score, ROM score difference were statistically significant （P 〈 0. 05） in the two groups before the operative and at the last follow-up. Complication rate of group B （7%） was lower than group A （39%） （P 〈 0. 05 ）. Conclusions The effect of PCL is satisfactory in the early follow-up fol- low-up. But it need further evaluation for more cases and lona-term follow-un.