颈前路减压cage植骨融合与自体髂骨植骨融合钛板内固定治疗脊髓型颈椎病对比研究

Comparative study on anterior cervical decompression and cage bone graft fusion versus autologous iliac bone graft fusion and internal titanium plate fixation in treatment of cervical spondylotic myelopathy

目的:探讨颈前路减压椎间融合器(cage)植骨融合与自体髂骨植骨融合钛板内固定治疗脊髓型颈椎病临床疗效。方法:选择某院治疗的脊髓型颈椎病患者(单节段)98例,按随机数表法分为2组,每组各49例。对照组接受自体髂骨植骨融合钛板内固定治疗,观察组接受颈前路减压cage植骨融合治疗。观察2组术中指标、手术前后颈椎脊髓功能、椎间高度、植骨融合情况及并发症。结果:观察组术中出血量为(31.47±2.92)mL、手术时间为(63.84±4.01)min,对照组分别为(56.29±3.37)mL,(87.98±5.63)min,2组比较差异有统计学意义(P<0.05);观察组并发症发生率(12.24%)低于对照组(34.69%),差异有统计学意义(P<0.05);手术前、后2组椎间高度、JOA评分比较,差异无统计学意义(P>0.05);术后2组椎间高度、JOA评分均比术前高,差异有统计学意义(P<0.05)。结论:将颈前路减压cage植骨融合术用于脊髓型颈椎病治疗中损伤小且安全性较高,利于获得良好的植骨融合效果。

Objective :To compare the clinical efficacy of anterioRcervical decompression and cage bone graft fusion versus autologous iliac bone graft fusion and internal titanium plate fixation in treatment of cervical spondylotic myelopathy (CSM). Methods :98 patients with CSM (single segment) treated in a hospital were selected and randomly divided into two groups, with 49 cases in each. The control group was given autologous iliac bone graft fusion and internal titanium plate fixation, while the observation group underwent anterioRcervical decompression and cage bone graft fusion.The intraoperative indexes,cervical spinal cord function, intervertebral height, bone graft fusion, and complications in the two groups were observed. Results :The intraoperative bleeding volume and operation time in the observation group[(31.47±2.92)ml,(63.84±4.01) min] were less than those of the control group [(56.29±3.37)ml,(87.98± 5.63)min]( P <0.05). The incidence of complications in the observation group (12.24%) was loweRthan that of the control group (34.69%)( P <0.05). Before and afteRsurgery, there was no statistical difference in the intervertebral height and JOA score between the two groups( P >0.05). AfteRsurgery, the intervertebral height and JOA score in the two groups were higheRthan those before surgery ( P <0.05). Conclusion :AnterioRcervical decompression and cage bone graft fusion in treatment of CSM has smalleRtrauma and higheRsafety.It can achieve betteRbone graft fusion effects, promote recovery of intervertebral height and cervical spinal cord function.