保留一侧肌肉韧带复合体联合椎间孔切开治疗脊髓型合并神经根型颈椎病的疗效及安全性分析

Efficacy and safety of cervical posterior one side muscle ligament complex-preserving foraminotomy on cervical myelopathy combined with radiculopathy

目的:探讨保留一侧肌肉韧带复合体联合椎间孔切开治疗脊髓型合并神经根型颈椎病的疗效及安全性。方法:选取128例脊髓型合并神经根型颈椎病患者为研究对象,按随机数字表法分为对照组和研究组,每组64例。研究组行颈后路保留一侧肌肉韧带复合体联合椎间孔切开治疗,对照组行颈后路单开门椎管成形术联合椎间孔切开治疗。比较两组手术情况、视觉模拟评分(VAS)、日本骨科协会评分(JOA)、颈椎功能残障指数表(NDI)和术后并发症发生率。结果:研究组手术时间和术中出血量均明显短于或少于对照组(P<0.05)。两组术后VAS评分、JOA评分、NDI评分、JOA改善率均明显优于术前(P<0.05),且研究组改善程度优于对照组(P<0.05)。研究组术后并发症总发生率明显低于对照组(P<0.05)。结论:颈后路保留一侧肌肉韧带复合体联合椎间孔切开治疗脊髓型合并神经根型颈椎病的临床疗效更为显著,能有效减轻患者颈部疼痛,改善脊髓功能,促进颈椎功能恢复,且安全性较高。

Objective：To investigate the efficacy and safety of cervical posterior one side muscle ligament complex-preserving foraminotomy for cervical myelopathy combined with radiculopathy.Methods：A total of128 patients with cervical myelopathy combined with radiculopathy were randomly assigned to receive either cervical posterior one side muscle ligament complex-preserving foraminotomy（study group,n=64）or open-door cervical laminoplasty combined with foraminotomy（control group,n=64）.The operation related indexes,visual analogue scale（VAS）score,Japanese orthopaedic association（JOA）score and neck disability index（NDI）as well as the incidence of postoperative complications were compared between the two groups.Results：The operation time and intraoperative blood-loss volume in the study group were significantly shorter/less than those in the control group（P〈0.05）.The VAS score,JOA score,NDI score and JOA improvement rate after operation were significantly better than those before operation in both groups（P〈0.05）,and the changes were more obvious in the study group（P〈0.05）.The incidence of postoperative complications in the study group was significantly lower than that in the control group（P〈0.05）.Conclusion：Cervical posterior one side muscle ligament complex-preserving foraminotomy was effective and safe for cervical myelopathy combined with radiculopathy.It could relieve neck pain,improve spinal cord function and promote cervical functional recovery of patients.