外视镜下行颈椎前路椎间盘切除融合术治疗颈椎病的疗效

Efficacy of anterior cervical discectomy and fusion using exoscope in the treatment of cervical spondylopathy

目的探讨外视镜下行颈椎前路椎间盘切除融合术(ACDF)治疗颈椎病的有效性和安全性。方法回顾性分析2017年3月至2019年3月复旦大学附属中山医院神经外科收治的15例颈椎病患者的临床资料,所有患者均行外视镜下ACDF。术后行临床随访和影像学随访,以患者的Odom评分和日本骨科协会(JOA)颈椎评分评估手术疗效。结果15例患者(19个节段)的手术用时为(100±6)min(80~160 min),术中出血量为(75±10)ml(40~150 ml)。椎间盘融合比例为19/19。1例患者术后发生一过性声音嘶哑,无一例死亡。所有患者均获随访,随访时间为(11.3±1.7)个月(3~27个月)。术后3个月的Odom评分结果表明,非常满意12例,满意3例。15例患者术后3个月的JOA颈椎评分为(15.8±0.2)分,高于术前的(13.3±0.4)分(t=5.8,P<0.01)。所有患者术后的症状均明显缓解,脊髓功能明显改善。结论外视镜下行ACDF治疗颈椎病的效果良好,且并发症少,值得在临床上推广应用。

Objective To investigate the effect and safety of anterior cervical discectomy and fusion(ACDF)using exoscope in the treatment of cervical spondylopathy.Methods From March 2017 to March 2019,15 patients with cervical spondylopathy were admitted to Department of Neurosurgery,Zhongshan Hospital Affiliated to Fudan University underwent ACDF using exoscope whose data were retrospectively analyzed.Odom scale and Japanese Orthopaedic Association(JOA)scale were used after operation to evaluate the effect of ACDF using exoscope.Results All 15 patients successfully underwent the surgeries.The operation time was 100±6 mins(80-160 mins).The bleeding volume was 75±10 ml(40-150 ml).The disc fusion ratio was 19/19.One patient had transient postoperative hoarseness and there was no death post operation.Fifteen patients were followed up for 3-27 months with an average of 11.3±1.7 months.The assessment result based on the Odom scale showed that 12 patients were very satisfied with the operation and 3 patients were satisfied with the operation.The mean JOA score of 15 patients was 15.8±0.2 points at 3 months post operation,which was higher than that prior to operation(13.3±0.4 points)(t=5.8,P<0.01).The symptoms of all patients were relieved and the spinal cord function was improved significantly.Conclusions The efficacy of ACDF using exoscope in the treatment of cervical spondylopathy seems good with few complications,which is worthy of being widely used.