短节颈椎前路椎间盘切除Cage融合钛板固定术对脊髓型颈椎病治疗效果、安全性及颈椎矢状位参数的影响

Effect of Short-segment Anterior Cervical Discectomy and Titanium Plate Cage Fixation on Efficacy,Safety and Cervical Spine Sagittal Parameters of Cervical Spondylotic Myelopathy

目的:分析短节段颈椎前路椎间盘切除Cage融合钛板固定术对脊髓型颈椎病颈椎治疗效果、安全性及颈椎矢状位参数的影响。方法:选取2018年5月-2020年5月于本院进行治疗的脊髓型颈椎病患者68例,根据倾向性评分将其分为对照组和研究组,每组34例。对照组实施传统标准开放手术治疗,研究组实施短节段颈椎前路椎间盘切除Cage融合钛板固定术治疗。比较两组手术相关指标、术前与术后6个月颈椎矢状位参数、术前与术后1周疼痛程度和颈椎功能、并发症发生情况。结果:研究组手术时间、术中出血量及术后引流量均少于对照组(P<0.05)。术后6个月,研究组C2~7 Cobb角、C2~7矢状轴向距离(C2~7 SVA)均小于对照组,SCobb角大于对照组(P<0.05);术后1周,研究组日本骨科学会(JOA)评分高于对照组,视觉模拟评分法(VAS)评分低于对照组(P<0.05);研究组并发症发生率低于对照组(P<0.05)。结论:在脊髓型颈椎病中应用短节段颈椎前路椎间盘切除Cage融合钛板固定术,可减少术中出血,缩短手术时间,减少术后并发症的发生,在矫正颈椎曲度上取得有效作用。

Objective:To analyze the effects of short-segment anterior cervical discectomy and titanium plate Cage fixation on efficacy,safety and cervical spine sagittal parameters of cervical spondylotic myelopathy.Method:A total of 68 patients with cervical spondylotic myelopathy treated in our hospital from May 2018 to May 2020 were selected.They were divided into control group and research group according to propensity score,with 34 cases in each group.The control group was treated with traditional standard open surgery,and the study group was treated with short-segment anterior cervical discectomy and titanium plate Cage fixation.The operation-related indexes,cervical spine sagittal parameters before and 6 months after surgery,the degree of pain and cervical spine function before and 1 week after surgery,the occurrence of complications were compared between the two groups.Result:The operative time,intraoperative blood loss and postoperative drainage volume in the study group were lower than those in the control group (P<0.05).6 months after surgery,the C2-7 Cobb angle and C2-7 sagittal axial distance (C2-7 SVA) of the study group were lower than those of the control group,while the SCobb angle of the study group was higher than that of the control group (P<0.05).1 week after surgery,the Japanese Orthopaedic Society (JOA) score of the study group was higher than that of the control group,and the visual analogue scale (VAS) score of the study group was lower than that of the control group (P<0.05).The incidence of complications in the study group was lower than that in the control group (P<0.05).Conclusion:In the treatment of cervical spondylotic myelopathy,the application of short-segment anterior cervical discectomy and titanium plate Cage fixation can reduce intraoperative bleeding,shorten the operation time,reduce the occurrence of postoperative complications,and achieve an effective effect on the correction of cervical curvature.