手术对男性脊髓型颈椎病伴勃起功能障碍患者的影响

Clinical effect analysis of surgery in the treatment male patients with cervical spondylotic myelopathy with erectile dysfunction

目的探讨颈椎前后路减压手术治疗男性脊髓型颈椎病伴勃起功能障碍患者的临床效果。方法回顾性分析2018年7月-2020年3月邯郸市中心医院骨科采用颈椎前后路手术治疗23例男性脊髓型颈椎病伴勃起功能障碍患者的临床资料。手术前和随访时,采用JOA评分评估患者脊髓功能状态和IIEF-5评分评估勃起功能障碍情况。计算JOA评分和IIEF-5评分的恢复率并进行相关分析,比较两种术式间IIEF-5评分恢复率的差异。结果23例患者均获得随访,平均12.3(6-20)月。随访时,JOA评分和IIEF-5评分均较术前显著改善,且有统计学差异(P<0.05)。IIEF-5评分恢复率与JOA评分恢复率之间存在明显的相关性(P=0.034),而颈椎不同术式间IIEF-5评分恢复率差异无统计学意义(P=0.821)。结论颈椎前后路减压手术除可改善脊髓功能外,还可改善勃起功能障碍。勃起功能障碍的改善与脊髓功能的恢复相关,但与手术入路无关。

Objective To evaluate the clinical effect of anterior and posterior cervical surgery in the treatment of male patients with cervical spondylotic myelopathy with erectile dysfunction.Methods Clinical data of 23 male patients with cervical spondylotic myelopathy and erectile dysfunction were retrospectively analyzed from July 2018 to March 2020 in the Department of Orthopedics,Handan Central Hospital.Before surgery and during follow-up,the JOA score was used to assess the patient’s spinal cord function,and the IIEF-5 score was used to assess the patient’s erectile dysfunction.The recovery rates of JOA score and IIEF-5 score were calculated and correlation analysis were carried out.Simultaneously,the difference between recovery rate of IIEF-5 score for different cervical spine surgery modes was comparatively analyzed.Results All23 patients were followed up with an average of 12.3(6-20) months.During the period of following-up,the JOA score and IIEF-5 score were all significantly improved compared with those preoperatively,and there was a statistical difference(P<0.05).There was a significant correlation between the recovery rate of the IIEF-5 score and the recovery rate of the JOA score(P=0.034).However,there was no statistically significant difference in the IIEF-5 score recovery rate between different cervical spine surgical procedures(P=0.821).Conclusion In addition to improving spinal cord function,cervical anterior and posterior surgery can also improve erectile dysfunction.The improvement of erectile dysfunction is correlated to the recovery of spinal cord function,but has nothing to do with surgical approach.