颈椎后路椎弓根螺钉内固定术治疗多节段脊髓型颈椎病患者的效果

Effects of posterior cervical pedicle screw internal fixation in treatment of patients with multi-segment cervical spondylotic myelopathy

目的:观察颈椎后路椎弓根钉内固定术治疗多节段脊髓型颈椎病(MCSM)患者的效果。方法:选取2018年10月至2020年10月该院骨科收治的68例MCSM患者进行前瞻性研究,根据随机数字表法分为研究组和对照组各34例。研究组采用颈椎后路椎弓根螺钉内固定术治疗,对照组采用颈椎后路单开门椎管扩大成形术治疗,比较两组手术前后神经功能[颈椎日本骨科协会评估治疗分数(JOA)]评分、疼痛程度[视觉模拟评分法(VAS)]评分、颈曲夹角和术后1个月并发症发生率。结果:术后6、12个月,两组颈椎JOA评分均高于术前,但组间比较,差异无统计学意义(P>0.05);术后7 d,两组VAS评分均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);术后6个月,两组颈曲夹角均大于术前,但组间比较,差异无统计学意义(P>0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:颈椎后路椎弓根螺钉内固定术治疗MCSM患者可降低术后VAS评分,效果优于颈椎后路单开门椎管扩大成形术治疗。

Objective: To observe effects of posterior cervical pedicle screw internal fixation in treatment of patients with multi-segment cervical spondylotic myelopathy(MCSM). Methods: A prospective study was conducted on 68 patients with MCSM admitted to the Department of Orthopedics of the hospital from October 2018 to October 2020. They were divided into study group and control group according to the random number table method, 34 cases in each. The study group was treated with posterior cervical pedicle screw internal fixation, while the control group was treated with posterior cervical single open-door laminoplasty. The neurological function [Japanese orthopaedic association(JOA)] score before and after the treatment, the pain level [visual analogue scale(VAS)] score, the cervical curvature, and the incidence of complications 1 month after the surgery were compared between the two groups. Results: 6 and 12 months after the surgery, the cervical JOA scores of the two groups were higher than those before the surgery, but there was no significant difference between the two groups(P>0.05). 7 days after the surgery, the VAS scores of the two groups were lower than those before the surgery, that of the study group was lower than that of the control group, and the differences were statistically significant(P<0.05). 6 months after the surgery, the cervical curvature angles of the two groups were greater than those before the surgery, but there was no significant difference between the two groups(P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusions: Posterior cervical pedicle screw internal fixation can reduce the postoperative VAS scores in the patients with MCSM. Moreover, it is superior to posterior cervical single open-door laminoplasty treatment.