显微镜辅助下颈前路减压植骨融合术治疗颈椎病疗效观察

Effect of microscope-assisted anterior cervical decompression and bone graft fusion in treatment of cervical spondylosis

目的:探讨显微镜辅助颈前路减压植骨融合内固定术治疗颈椎病的早期临床效果。方法:回顾分析2016年1月至2018年4月诊治的25例在显微镜辅助下行颈前路减压植骨融合术治疗颈椎病患者的临床资料,并对患者进行1年随访,记录手术时间、术中出血量、术后引流量、术中术后并发症情况,记录术前及末次随访JOA评分、NDI指数、椎间高度及植骨融合情况并计算神经功能改善率。结果:25例均获得随访,随访时间12.4~18.8个月。术后未出现脊髓神经损伤,1例术后出现吞咽困难,治疗后缓解。末次随访时JOA评分、NDI指数、椎间隙高度均较术前改善,差异有统计学意义(P<0.05)。术后神经功能改善率优19例、良3例、可3例,优良率为88%;25例均融合,融合率100%。结论:显微镜辅助颈前路精细减压植骨融合内固定术治疗颈椎病可取得良好的早期临床疗效,术后患者脊髓神经功能均恢复良好、临床症状得到改善;同时显微镜下手术具有创伤小、减压彻底、安全性高的优点。

Objective:To investigate the clinical efficacy of microendoscopic anterior discectomy,cage bone graft fusion and internal titanium plate fixation in the treatment of cervical diseases.Methods:From January 2016 to April 2018,the clinical data of 25 patients with cervical diseases treated by microendoscopic anterior discectomy,cage bone graft fusion and internal titanium plate fixation were analyzed retrospectively.All patients were followed up for 1 year after surgery.The operation time,intraoperative blood loss and complications were recorded.The preoperative and postoperative JOA score,NDI score,intervertebral height,situation of bone graft fusion and the improvement rate of nerve function were assessed.Results:25 cases were followed up for 12.4 to 18.8 months.All patients had no spinal cord and never root injury,1 case had dysphagia after surgery,and the symptoms disappeared after symptomatic treatment.The JOA score,NDI score,intervertebral height,were improved at 1 year after surgery,the difference was statistically significant(P<0.05).The curative effect was excellent in 19 cases,good in 3 cases,fair in 3 cases,poor in 0 case,the improvement rate of neurological function after microsurgery was 88%.25 cases underwent bone graft fusion,the fusion rate was 100%.Conclusion:The good treatment outcomes were observed in anterior cervical decompression and internal fixation for cervical diseases under microscope compared with traditional operation.The recovery of spinal cord and never root function are good,and alleviate the clinical symptoms.The advantages is small injury,complete decompression and good safety of operation.