颈椎前路混杂手术治疗颈椎退行性疾病35例

35 Cases of Cervical Hybrid Surgery for Cervical Degeneration Diseases

目的:评价颈椎前路Hybrid手术治疗颈椎退行性疾病的近期临床疗效。方法:纳入本院2017年6月至2018年6月接受颈椎前路Hybrid手术的患者,采集术前、术后3,6及12个月的评估结果,包括颈肩部和手臂痛的视觉模拟评分(VAS评分)、颈椎JOA评分及患者术后满意度(Odom’s评分)。结果:最终纳入符合纳排标准的患者35例,男16例,女19例;年龄39~70岁,平均(55.46±7.69)岁;出血量20~100 mL,平均(40.00±18.31)mL;手术时间1.28~6.00 h,平均(2.98±1.08)h;住院时间4~29 d,平均(12.29±6.36)d.临床疗效:术前至术后12个月,颈肩和手臂痛VAS评分逐渐降低,各时间点比较差异有统计学意义(P<0.01);术后6~12个月,症状略有反复,差异无统计学意义(P>0.05)。末次随访时JOA评分(16.29±1.20)分,较术前(14.71±2.04)分明显升高,差异有统计学意义(P<0.01),JOA评分改善率为(58.21±0.48)%。末次随访时非常好和好的比例为91.40%(32/35).结论:在术后1年中,有超过91.40%的Hybrid手术患者表示非常满意和满意,证明颈椎前路Hybrid手术可以让患者明显受益,但术后1年患者颈痛症状略有反复,仍需长期随访并进一步深入研究。

Objective:Short-term clinical efficacy of cervical hybrid surgery for cervical degeneration diseases(CDD).Methods:Inpatients diagnosed with CDD who underwent Hybrid surgery between 2017-06 and 2018-06 were prospectively studied.Clinical outcomes were assessed by neck and arm visual analogue scale(VAS score),Japanese Orthopedic Association scale(JOA score)and Odom’s criteria at pre-operation and 3,6,12 months postoperatively.Results:35 inpatients including 16 male and 19 female with age of 39~70 years(55.46±7.69)had been enrolled.The intraoperative blood loss was 20~100 mL(40.00±18.31),the surgery time was 1.28~6.00 h(2.98±1.08),length of stay was 4~29 d(12.29±6.36).In this study,neck and arm pain was gradual decreasing from pre-operation to 12 months post-operation(P<0.01).The last follow up JOA score(16.29±1.20)was higher than pre-operation(14.71±2.04)(P<0.01),JOA improvement rate was(58.21±0.48)%.The excellent and good rate based on Odom’s criteria was 91.40%(32/35).Conclusion:Base on the Odom’s criteria,91.40%patients judge the result of this surgical procedure as being excellent and good,which exhibits the Anterior cervical hybrid surgery provides a favorable clinical outcome in the period of 1 year.However,the symptom of neck pain was slightly repeated 1 year after surgery,which means long-term follow-up is essential in further study.