颈前路减压手术治疗颈椎病伴头晕的疗效

Effect of anterior cervical decompression surgery for cervical spondylosis with dizziness

目的 研究颈椎病伴头晕的患者经颈前路手术治疗后的疗效并进一步分析其发病机制。方法 回顾性分析2015年6月—2018年6月解放军总医院第三医学中心将51名颈椎病伴头晕患者纳入该研究,并在术后至少随访1年。主要观察指标是头晕的强度和频率的变化,次要观察指标为改良的日本骨科学会(mJOA)神经功能评分的变化。结果 手术时间50~80 min,平均65 min,术中出血量40~150 mL,平均75 mL;住院时间6~10 d,平均7 d。所有患者均顺利完成手术,切口均一期愈合。至末次随访,51名患者复查均未见螺钉松动、断裂或cage移位。术后患者头晕强度和头晕频率随时间的推移逐渐降低,并且这种效果持续到手术后12个月。与基线值相比,术后mJOA评分显著改善,差异具有统计学意义。结论 本研究显示颈前路减压手术可以有效缓解头晕症状,改善患者的生活质量。

Objective To analyze the mechanisms of anterior cervical surgery for dizziness relief effectiveness in patients with cervical spondylosis.Methods Altogether 51 patients with cervical spondylotic radiculopathy or myelopathy accompanying dizziness who failed to conservative treatment for at least 3 months and underwent anterior cervical discectomy and fusion surgery,were enrolled for current study from June,2015 to June,2018.Each patient was followed up at least 1year.The primary outcomes were measures of intensity and frequency of dizziness.The secondary outcomes were changes of Modified Japanese Orthopaedic Association(mJOA) score.Results The average surgical time was 65 min(range,50~80 min),an average loss of blood was 75 mL(range,40~150 mL),the average time of hospitalization was 7 days(range,6~10 days).All patients were operated successfully and the incisions healed in one stage.No loosening and breakage of screws or cage displacement was found among the 51 patients at the final followup.There were significant decreases in intensity and frequency of dizziness after treatment compared with baseline.There was a significant improvement in mJOA scores in these surgery patients.Conclusion sCurrent clinical study clearly indicates that anterior cervical surgery can markedly relieve concomitant dizziness and improve the quality of life for the patients with cervical spondylosis.