显微镜下颈前路椎间盘切除植骨融合术与颈前路椎体次全切除植骨融合术治疗多节段颈椎病患者的效果对比

Comparison of the Effect of Microscopic Anterior Cervical Discectomy and Fusion and Anterior Cervical Corpectomy and Fusion in Patients with Multilevel Cervical Spondylosis

目的:观察显微镜下颈前路椎间盘切除植骨融合术(ACDF)与颈前路椎体次全切除植骨融合术(ACCF)治疗多节段颈椎病患者的效果。方法:将丰城市人民医院骨科2020年6月-2021年6月收治的118例多节段脊椎病患者纳入研究,以简单随机化法分为观察组与对照组,各59例。对照组采取ACCF治疗,观察组采取显微镜下ACDF治疗。比较两组手术相关指标、神经功能、颈椎疼痛程度、颈椎曲度与并发症发生情况。结果:观察组手术时间与住院时间较对照组均更短,术中出血量较对照组更少(P<0.05);两组术前日本骨科协会评估治疗(Japanese orthopaedic association,JOA)评分、颈椎功能障碍指数(neck disability index,NDI)评分及颈椎曲度比较,差异均无统计学意义(P>0.05);观察组术后6个月JOA评分高于对照组,且JOA改善率优于对照组(P<0.05);术后6个月观察组颈椎疼痛评分低于对照组,颈椎曲度高于对照组(P<0.05);观察组并发症发生率为5.08%,低于对照组的16.95%(P<0.05)。结论:与ACCF术比较,显微镜下ACDF术治疗多节段颈椎病患者更有利于缩短手术时间及住院时间,减少患者术中出血量,改善神经功能,缓解患者颈椎疼痛,调节颈椎曲度,且术后并发症较少。

Objective:To observe the effect of anterior cervical discectomy and fusion(ACDF)and anterior cervical corpectomy and fusion(ACCF)in the treatment of patients with multilevel cervical spondylosis under the microscope.Method:A total of 118 patients with multilevel spondylopathy who were admitted to the Department of Orthopedics in Fengcheng People's Hospital from June 2020 to June 2021 were included in the study and were divided into observation group and control group by simple randomization,with 59 cases in each group.The control group was treated with ACCF,and the observation group was treated with ACDF under microscope.The operationrelated indexes,neurological function,cervical pain degree,cervical curvature and complications were compared between the two groups.Result:The operation time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group(P<0.05).There were no statistically significant differences in the Japanese orthopedic association(JOA)score,neck disability index(NDI)score and cervical curvature before surgery between the two groups(P>0.05).The JOA score of the observation group was higher than that of the control group 6 months after surgery,and the JOA improvement rate was better than that of the control group(P<0.05).After 6 months of surgery,the cervical pain score in the observation group was lower than that in the control group,and the cervical curvature was higher than that in the control group(P<0.05).The incidence of complications in the observation group was 5.08%,lower than the 16.95%in the control group(P<0.05).Conclusion:Compared with ACCF,ACDF under the microscope is more beneficial to shorten the operation time and hospital stay,reduce the blood loss during the operation,improve the nerve function,relieve the pain of the cervical spine,and adjust the cervical curvature.The postoperative complications are less.