一期前后路联合手术治疗脊髓性颈椎病患者临床疗效及椎间盘组织IL-10、IL-1β及TNF-α表达

Clinical efficacy and expression of IL-10,IL-1β and TNF-α in intervertebral disc tissue in patients with cervical spondylotic myelopathy treated by one-stage anterior and posterior approach

目的 探讨一期前后路联合手术治疗脊髓性颈椎病患者临床疗效及椎间盘组织白介素-10(IL-10)、白介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)表达。方法 选取2020年1月至2022年1月于郑州大学第五附属医院医治的107例脊髓性颈椎病患者,按照脊髓型颈椎病术式主要分为前路手术组(n=35),后路手术组(n=33),前后路联合手术组(n=39),术后记录不同手术方法的临床疗效、比较前后路联合手术组不同疗效患者椎间盘组织IL-10、IL-1β及TNF-α水平,同时分析临床疗效与IL-10、IL-1β及TNF-α的相关性。结果 临床疗效:前后路联合手术组>前路手术组>后路手术组,组间差异具有统计学意义(P<0.05)。IL-10、IL-1β及TNF-α水平:优<良<可<差,组间差异具有统计学意义(P<0.05)。Spearman相关分析显示,IL-10、IL-1β、TNF-α与临床疗效呈正相关(P<0.05)。结论 一期前后路联合手术可有效治疗脊髓性颈椎病,同时IL-10、IL-1β、TNF-α与临床疗效存在一定的相关性,可为临床病情诊断提供参考。

Objective To explore the clinical effect of one-stage anterior posterior combined surgery for cervical spondylotic myelopathy. Methods The clinical data of 107 patients with cervical spondylosis treated in our hospital from January 2020 to January 2022 were selected,and according to the surgical methods of cervical spondylotic myelopathy,they were divided into the anterior surgery group(n=35),the posterior surgery group(n=33),the combined anterior and posterior approach group(n=39),the clinical efficacy of different surgical methods were recorded after operation,and the levels of IL-10,IL-1β and TNF-α in the intervertebral disc tissue of patients with different curative effects in the combined anterior and posterior approach group were compared,and the correlation between clinical curative effect and IL-10,IL-1βand TNF-α was analyzed. Results The excellent and good rate of clinical efficacy in the posterior combined operation group was higher than that in the anterior and posterior operation groups,and the difference between the groups was statistically significant(P<0.05). The levels of IL-10. IL-1β and TNF-α in the excellent and good groups was lower than those in the acceptable and poor groups,the difference between groups was statistically significant(P<0.05). Spearman correlation analysis showed that IL-10,IL-1β,TNF-α were positively correlated with clinical efficacy(P<0.05). Conclusion One-stage combined anterior and posterior surgery can effectively treat cervical spondylotic myelopathy. At the same time,IL-10,IL-1β,and TNF-α have a certain correlation with clinical efficacy,which can provide reference for clinical diagnosis.