观察颈椎不同入路方式减压内固定治疗多节段脊髓型颈椎病的疗效

Observation on the effect of decompression and internal fixation with different approaches of cervical spine in the treatment of multi-segmental cervical spondylotic myelopathy

目的:探讨不同入路方式减压内固定治疗多节段脊髓型颈椎病的疗效。方法:收治多节段脊髓型颈椎病患者60例,随机平分两组,对照组对患者进行全麻,在颈部后方正中进行切开,观察组对患者进行全麻,在颈部侧方进行切开,观察和比较两组患者的治疗前和治疗后的神经功能(JOA评分)和影像学观测指标。结果:与对照组对比,观察组JOA评分明显更低(P<0.05);与治疗前对比,观察组治疗后JOA评分明显降低(P<0.05)。与对照组对比,观察组ROM明显更低,CCI明显更高(P<0.05);与治疗前对比,观察组治疗后ROM明显降低,CCI明显升高,P<0.05。结论:颈前路和后路入路减压内固定手术都能够有效地治疗多节段脊髓型颈椎病,但是与后路入路方式对比,前路入路方式疗效更为显著。

Objective:To observe the effect of decompression and internal fixation with different approaches of cervical spine inthe treatment of multi-segmental cervical spondylotic myelopathy.Methods:60patients with multi-segmental cervical spondyloticmyelopathy were selected,they were randomly divided into the two groups on average,patients in the control group underwentgeneral anesthesia and were incised in the back of the neck,the patients in the observation group underwent general anesthesiaand were incised at the neck side,the neurological function(JOA score)and imaging parameters were observed and comparedbetween the two groups before and after treatment.Results:Compared with the control group,the JOA score of the observationgroup was significantly lower,P<0.05.Compared with before treatment,the JOA score of the observation group was significantlylower after treatment,P<0.05.Compared with the control group,the ROM of the observation group was significantly lower,and theCCI was significantly higher,P<0.05.Compared with before treatment,the ROM in the observation group decreased significantly,and the CCI increased significantly,P<0.05.Conclusions:Anterior and posterior approach decompression and internal fixation areeffective for the treatment of multi-segmental cervical spondylotic myelopathy.However,anterior approach is more effective thanposterior approach.