颈椎前路椎体次全切减压钛网植骨联合钛板固定椎板成形术对62例颈椎病患者颈椎活动度及生活质量的影响分析

Effect of Anterior Cervical Vertebral Subtotal Decompression Titanium Mesh Bone Grafting and Ti-plate Fixation Laminectomy on Cervical Motion and Life Quality of 62 Cervical Spondylosis Patients

目的探究颈椎前路椎体次全切减压钛网植骨联合钛板固定椎板成形术对脊髓型颈椎病(CSM)患者颈椎活动度及生活质量的影响。方法方便选取2014年6月—2017年5月该院收治的124收治例行择期手术治疗的CSM患者为研究对象,采用随机数字表法分为对照组和观察组,各62例。对照组给予颈椎前路椎体次全切减压钛网植骨融合术,观察组则在此基础上予以钛板固定椎板成形术。比较两组术前及术后6个月时手术节段屈伸活动度(ROM)、生活质量[颈痛量表(NPQ)]差异,并记录两组术后12个月时临床疗效、植骨融合情况差异。结果术后6个月时,两组手术节段ROM[(6.08±1.21)°vs(13.05±1.86)°、(4.68±0.82)°vs(13.39±1.59)°]均较术前降低(t=24.733、38.336,P<0.05),且对照组低于观察组(t=7.542、P<0.05);两组NPQ评分[(15.92±3.14)分vs(24.27±4.25)分、(18.53±3.61)分vs(23.49±4.16)分]亦较术前降低(t=12.443、7.091,P<0.05),但观察组低于对照组(t=4.295,P<0.05)。术后12个月时,观察组临床疗效及植骨融合情况均优于对照组(Z=6.429、5.933,P<0.05)。结论颈椎前路椎体次全切减压钛网植骨联合钛板固定椎板成形术可提高CSM患者术后颈椎活动度,并改善其生活质量,还能提升手术效果,于患者预后有利。

Objective This paper tries to investigate the effect of anterior cervical corpectomy and decompression titanium mesh grafting combined with titanium plate laminectomy on cervical vertebra activity and quality of life in patients with cervical spondylotic myelopathy（CSM）. Methods A total of 124 CSM patients undergoing elective surgery in the hospital from June 2014 to May 2017 were convenient selected and divided into a control group and an observation group with 62 random cases. The control group was given anterior cervical vertebral subtotal decompression titanium mesh bone graft fusion, and the observation group was given titanium plate fixation laminectomy. The differences in ROM and quality of life（NPQ） between the two groups before surgery and at 6 months after operation were compared. The clinical efficacy and bone graft fusion situation difference at 12 months after operation were recorded. Results At 6 months postoperatively, ROM（6.08±1.21）°s vs（13.05±1.86）°,（4.68±0.82）° vs（13.39±1.59）° of the two groups were lower than before the operation（t=24.733, 38.336,P〈0.05）, and the control group was lower than the observation group（t=7.542, P〈0.05）; the NPQ scores of the two groups were（15.92±3.14） points vs（24.27±4.25） points,（18.53±3.61） points vs（23.49±4.16） points also decreased compared with before surgery（t=12.443, 7.091, P〈0.05）, but the observation group was lower than the control group（t=4.295, P〈0.05）. At12 months after operation, the clinical efficacy and bone graft fusion in the observation group were better than those in the control group（Z =6.429, 5.933, P 0.05）. Conclusion Anterior cervical corpectomy combined with decompression titanium mesh grafting and titanium plate fixation laminectomy can improve the cervical vertebrae mobility after CSM, improve their quality of life,and improve the surgical outcome