摘要
目的:探讨颈椎前路Hybrid术治疗颈椎退行性疾病的临床疗效并观察其术后1年影像学上间盘置换节段异位骨化的发生率。方法:对2015年1月至2018年4月接受颈椎前路Hybrid术符合纳入和排除标准并获得完整临床随访资料的35例患者进行回顾性分析,其中24例获得完整影像学随访资料,男15例,女20例,年龄39~70(55.57±7.73)岁,手术出血量20~100(40.29±18.39)ml,住院时间4~28(11.03±4.63)d,随访时间(12.97±1.36)个月。采用田中靖久颈椎病症状量表(Tanaka Yasushi Cervical Spondylitis Symptom Scale 20 Score,YT20)及日本矫形骨科协会(Japanese Orthopaedic Association,JOA)评分进行临床疗效评价,术后1年通过X线依据McAfee标准评价Hybrid术后异位骨化发生的情况,并对是否发生异位骨化患者进行分组,比较其临床疗效。结果:末次随访时平均YT20评分和JOA评分较术前明显升高(P<0.05),JOA平均改善率为(70.66±0.44)%。24个节段中10个节段出现异位骨化,发生率为41.70%,其中Ⅰ级为29.20%,Ⅱ级为12.50%。异位骨化发生和未发生患者的临床疗效比较:术前、术后JOA评分差异无统计学意义(P>0.05);术前YT20评分差异无统计学意义(P>0.05),术后异位骨化发生患者YT20评分明显低于未发生患者。结论:Hybrid术近期临床疗效满意,异位骨化发生的原因仍需要进一步探索。
Objective:To investigate the clinical effect of anterior cervical Hybrid surgery in the treatment of cervical degenerative diseases(CDD)and observe the incidence of heterotopic ossification of disc replacement segment at 1 year after surgery.Methods:From January 2015 to April 2018,35 patients who received anterior cervical hybrid surgery met the inclusion and exclusion criteria and the complete clinical follow-up data were analyzed retrospectively.Complete imaging follow-up data were obtained from 24 patients.There were 15 males and 20 females,aged from 39 to 70(55.57±7.73)years old.The amount of bleeding was for 20 to 100(40.29±18.39)ml,and the hospital stay was for 4 to 28(11.03±4.63)days,and the follow-up time was(12.97±1.36)months.Clinical outcomes were assessed by the Tanaka Yasushi cervical spondylitis symptom scale 20 score(YT20),and Japanese Orthopaedic Association(JOA)score.The occurrence of heterotopic ossification after Hybrid surgery was evaluated by X-ray according to McAfee standard one year after operation.Patients with or without heterotopic ossification were divided into two groups and their clinical effects were compared.Results:At the final follow-up,the mean YT20 score and JOA score were significantly higher than those before operation(P<0.05),and the average improvement rate of JOA was(70.66±0.44)%.One year after operation,the heterotopic ossification occurred in 10 of 24 segments,with incidence of 41.70%(10/24),including 29.20%in gradeⅠand 12.50%in gradeⅡ.The results of clinical efficacy comparison between patients with and without heterotopic ossification were as follows:there was no significant difference in JOA score before and after operation(P>0.05);there was no significant difference in YT20 score before operation(P>0.05),and YT20 score in patients with heterotopic ossification was significantly lower than that in patients without heterotopic ossification(P<0.05).Conclusion:The short-term clinical effect of Hybrid surgery is satisfactory for cervical degenerative diseases,and the cause of heterotopic ossification still needs to be further explored.
作者
齐英娜
李春根
柳根哲
尹辛成
彭亚
孙佩宇
陈超
郑皓云
祝永刚
郭雨霞
QI Ying-na;LI Chun-gen;LIU Gen-zhe;YIN Xin-cheng;PENG Ya;SUN Pei-yu;CHEN Chao;ZHENG Hao-yun;ZHU Yong-gang;GUO Yu-xia(Department of Orthopaedics,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)
出处
《中国骨伤》
CAS
CSCD
2021年第1期80-85,共6页
China Journal of Orthopaedics and Traumatology
关键词
颈椎退行性疾病
Hybrid术
异位骨化
Cervical degenerative diseases
Hybrid surgery
Heterotopic ossification