To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type （CSVAT） patients. Methods： In the present study, m...To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type （CSVAT） patients. Methods： In the present study, methods of evidence-based medicine, triple-centers, single-blindness, randomization and control were used. A total of 100 cases of CSVAT patients were randomized into acupuncture plus massage （acu-massage） group （n = 38）, acupuncture group （n = 32） and massage group （n = 30）. Acupoints used were Fengchi （风池, GB 20）, cervical Jiaji （颈夹脊 EX-B 2）, Baihui （百会 GV 20）, and the methods of massage used were kneading-rolling, adhesion-separating and acupoint-digital pressing, topical digital pressing and rubbing, traction-extending and mild palm-rubbing. The treatment was conducted once daily, with 7 sessions being a therapeutic course and continuously for 2 courses. Changes of peak velocity （Vp）, end-diastolic velocity （Vd）, mean velocity （Vm） of blood flow of the vertebral artery （VA） and basilar artery （BA）, etc were detected before and after the treatment by using transcranial Doppler （TCD） ultrasonography. Resuits： After the treatment, the abnormally low Vp of both VA and BA in acu-massage, acupuncture and massage groups, Vm of VA in acu-massage and acupuncture groups, Vm of BA in acu-massage and massage groups, and Vd of VA and BA in the 3 groups all increased significantly in comparison with their own pretreatment（ P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group in the 3 indexes were significantly superior to those of acupuncture group and/or massage group （P 〈0.05, 0.01 ）. The abnormally increased Vp of VA in acu-massage and acupuncture groups, Vm of VA in the 3 groups, and Vd of VA in acu-massage and massage groups decreased obviously after the treatment in comparison with their own pretreatment （P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group were significantly superior to those of acupuncture and/or massage group in the 3 indexes of VA （P〈0.05, 0.01）. In addition, the abnormally increased Vp, Vm and Vd of BA in the 3 groups showed a similar tendency. No significant differences between acupuncture and massage groups in 3 indexes （ P 〉0.05）. Conclusion： The therapeutic effects of acupuncture plus massage is significantly superior to those of simple acupuncture and simple massage therapies in improving abnormal blood dynamics of vertebral and basilar arteries in CSVAT patients.展开更多
Cervical spondylosis of vertebral artery type is one of the chief patterns of cervical spondylosis.It is often described as neck pain accompanied with radiating pain and neurologic symptoms,such as sudden dizziness,bl...Cervical spondylosis of vertebral artery type is one of the chief patterns of cervical spondylosis.It is often described as neck pain accompanied with radiating pain and neurologic symptoms,such as sudden dizziness,blurred vision,tinnitus,nausea,vomiting,memory loss,and sudden fainting.The incidence of cervical spondylosis increases and patients with cervical spondylosis become progressively younger.Acupuncture in the cervical spondylosis of vertebral artery type treatment has a local positive reaction“Liuhe point”,in order to dredge the local Qi and blood.More and more evidences into the effectiveness and safety of cervical spine acupuncture for cervical spondylosis,specific neck pain,cervical radiculopathy,etc.This article summarizes the recent literature on acupuncture and acupuncture combined with other therapies for cervical spondylosis of vertebral artery type treatment and provides a comprehensive review from the perspectives of acupuncture therapy,warm needle moxibustion therapy,electroacupuncture,and acupuncture combined with other therapies,in order to provide reference and reference for clinical treatment.展开更多
Objective.To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis （VACS）. Methods： In the present study, triple-center, single-blind,...Objective.To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis （VACS）. Methods： In the present study, triple-center, single-blind, randomized and control methods were adopted. Qualified subjects were randomly assigned to three groups： acupuncture-massage （acu-mas） group, acupuncture group, and massage group （60 subjects in each group）. Bilateral Fengchi （风池 GB 20）, Jiaji （夹脊 EX-B 2, C4-7） and Baihui （百会 GV 20） ware punctured in combination with massage at the neck-shoulder and back region. The treatment was conducted once daily, 14 times altogether. Results. After treatment, of the 60 cases in each of acu-mas, acupuncture and massage groups, 28, 11 and 13 were cured, 13, 20 and 17 markedly effective, 12, 14 and 16 effective, and 7, 15 and 14 ineffective, with the total effective rates being 88.3%, 75.0% and 76.7% respectively. The therapeutic effect of acu-mas group was significantly superior to that of simple acupuncture and massage groups （P〈 0.05）. The scores of clinical symptoms and signs in 3 groups all declined significantly after treatment （ P〈 0.01 ）, and the score of symptoms of acu-mas was markedly lower than those of acupuncture and massage groups （P〈 0.05）. No significant differences were found among 3 groups in the score of clinical signs and between acupuncture and massage groups in the score of clinical symptoms （P〉0.05）. The time for producing therapeutic effects in acu-mas group was significantly shorter than those of acupuncture and massage groups （P〈0.01, 0.05）, meanng a faster of aou-mas group in producing clinical effect. No adverse events ware found in all the 3 groups. Conclusion： Acupuncture and massage are effective and safe in the treatment of VACS, and the therapeutic effect of acupuncture combined with massage is superior to that of simple acupuncture and simple massage therapy.展开更多
we studied 30 vertebral arterial insufficiency type cervical spondylosis patients and 30sex and age matched healthy controls by detecting their serum endothelin (ET) levels with radioimmuuoassay (RIA).At the same time...we studied 30 vertebral arterial insufficiency type cervical spondylosis patients and 30sex and age matched healthy controls by detecting their serum endothelin (ET) levels with radioimmuuoassay (RIA).At the same time, we selected 20 severe patients for operation therapy,and compared their serum ET levels before and after operation.The results showed that 30 patients had higher ET levels [(119. 46±58.65)ng/L] than those of the controls [(38. 43±14.33)ng/L], and the 20 patients had higher ET levels before operation [(139. 34±52. 56)ng/L] than after operation [(50.84±21. 67)ng/L)].Both have statistical significance (P<0.001 ).Therefore, we think that serum ET is one or important humoral factors contributing to vertebral arterial insufficiency type cervical spondylosis.It may be useful in treating verteibral arterial insufficiency type cervical spondylosis with effective ET-antibody, inhibitor or ET converting enzyme and special ET receptor blocker.展开更多
Objective To compare the differences in the efficacy on cervical spondylosis of the vertebral artery type （CSA） treated with the warm needling therapy combined with the rehabilitation physiotherapy, the simple warm ...Objective To compare the differences in the efficacy on cervical spondylosis of the vertebral artery type （CSA） treated with the warm needling therapy combined with the rehabilitation physiotherapy, the simple warm needling therapy and the simple rehabilitation physiotherapy separately and observe the impacts of them on the vertebral basilar artery （VBA） in hemodynamics. Methods Ninety cases of CSA patients were randomized divided into an acupuncture plus rehabilitation group, a warm needling group and a rehabilitation group, 30 cases in each. In the acupuncture ＋ rehabilitation group, the warm needling therapy was used at Jiájǐ （夹脊 EX-B 2） from C3 to C7 in combination with the rehabilitation physiotherapy such as traction and magnetic therapy. In the warm needling group, the simple warm needling therapy was applied. In the rehabilitation group, the simple rehabilitation physiotherapy was adopted. The VBA hemodynamic parameters, Vp, Vd, Vm and PI values were detected under the transcranial Doppler and taken as the indexes for the efficacy assessment of the groups. The efficacy of each group was assessed in association with the clinical curative rate. Results After treatment, the VBA hemodynamic parameters, Vp, Vd, Vm and PI values were all remarkably improved as compared with those before treatment in the three groups （P〈0.01, P〈0.05）. The improvement of the indexes in the acupuncture plus rehabilitation group were more significant as compared with either of the other two groups （all P〈0.01）. The clinical curative rate was 70.0% （21/30） in the acupuncture plus rehabilitation group, which was superior to 53.3% （16/30） in the warm needling group and 53.3% （16/30） in the rehabilitation group （all P〈0.01）. Conclusion The warm needling in combination with the rehabilitation physiotherapy significantly improves in VBA hemodynamic parameters for CSA and its clinical efficacy is superior to either the simple warm needling or the rehabilitation physiotherapy. Hence, this combined therapy was highly deserved to be promoted in clinical practice.展开更多
OBJECTIVE:To determine the clinical effect,treatment times,and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations.METHODS:One hundred and twent...OBJECTIVE:To determine the clinical effect,treatment times,and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations.METHODS:One hundred and twenty six cervical spondylosis patients(vertebral artery type) were randomly divided into test and control groups.Patients in the test group were treated with innovative Tuina manipulations,while those in the control group were treated with the routine Tuina manipulations according to the textbook of Chinese Massage for Acupuncture and Moxibustion majors.The clinical effects,treatment times,clinical symptoms,and cerebral blood flow were measured.RESULTS:The response to the treatment was 100% in the test group and 88.71% in the control group.Patients in the test group required(7 ± 4) treatments before recovery,while those in the control group required(15 ± 7) treatments before recovery(P<0.05).The clinical symptoms exhibited greater improvement in the test group compared to the control group(P<0.05).There were no differences in cerebral blood flow between the two groups.CONCLUSION:Both innovative Tuina manipulations and routine Tuina manipulations produced satisfactory therapeutic results in vertebral artery type cervical spondylosis patients.However,the innovative manipulation was more effective in improving the functional symptoms,although there were no changes in the cerebral blood flow.展开更多
Objective To verify the clinical efficacy of the filiform-fire needling therapy on cervical spondylosis of vertebral artery type（CSA）.Methods One hundred and twenty cases of CSA were treated with the filiform-fire n...Objective To verify the clinical efficacy of the filiform-fire needling therapy on cervical spondylosis of vertebral artery type（CSA）.Methods One hundred and twenty cases of CSA were treated with the filiform-fire needling therapy.The acupoints were Bǎihuì（百会 GV 20）,Fēngchí（风池 GB 20）,Nǎohù（脑户 GV 17）,Jìngbǎiláo（颈百劳 EX-HN 15）,etc.The needles were inserted rapidly and retained for 20 min.The treatment was given once a day.7 treatments made 1 session.The efficacy was assessed after 1 session of treatment.Results Eighty-eight cases were effective markedly,accounting for 73.3%.Twenty-seven cases were effective,accounting for 22.4%.Five cases were failed,accounting for 4.2%.The total effective rate was 95.8%.Conclusion The filiform-fire needling therapy achieves the significant efficacy on CSA.展开更多
目的浅析椎动脉型颈椎病(cervical spondylotic vertebral arteriopathy,CSA)患者实施基于“筋骨平衡”理论针刺推拿疗法对其中医症状积分、颈性眩晕症状与功能评估量表(cervical vertigo symptom and function assessment scale,ESCV)...目的浅析椎动脉型颈椎病(cervical spondylotic vertebral arteriopathy,CSA)患者实施基于“筋骨平衡”理论针刺推拿疗法对其中医症状积分、颈性眩晕症状与功能评估量表(cervical vertigo symptom and function assessment scale,ESCV)评分、颈椎曲度及脑血流参数的影响。方法选择该院2019年12月—2021年12月就诊的CSA患者86例实施研究,随机数字表法分作观察组与对照组,各43例;其中对照组脱落2例,剔除1例,共完成40例;观察组脱落1例,剔除1例,共完成41例;对照组予以常规牵引疗法,观察组予以基于“筋骨平衡”理论针刺推拿疗法;比较两组治疗前与治疗后中医症状积分、ESCV评分、颈椎曲度及脑血流参数的变化,并对比两组疗效。结果治疗后,观察组中医症状积分皆显著低于对照组(P<0.05)。治疗后,观察组ESCV评分和颈椎曲度皆明显高于对照组(P<0.05)。治疗后,观察组椎底动脉及左、右椎动脉的Vs与Vd水平均显著高于对照组(P<0.05)。观察组总有效率显著高于对照组[95.12%(39/41)vs 80.00%(32/40),P<0.05]。结论基于“筋骨平衡”理论针刺推拿疗法对CSA患者疗效显著,有效改善中医症状积分、ESCV评分以及颈椎曲度,增强脑血流参数。展开更多
目的:探讨颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床效果。方法:回顾性分析2020年1月至2022年1月42例CSA患者的临...目的:探讨颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床效果。方法:回顾性分析2020年1月至2022年1月42例CSA患者的临床资料,男25例,女17例;年龄30~74(53.9±11.0)岁。单节段病变18例,2个节段病变17例,3个节段病变7例。分别在术前和术后6个月时采用美国耳鼻咽喉头颈外科学会听力及平衡委员会评分(Committee on Hearing and Equilibrium,CHE)、颈椎功能障碍指数(neck disability index,NDI)和颈椎曲度Cobb角进行临床疗效评价。结果:42例患者均获随访,随访时间6~30(14.0±5.2)个月;手术时间95~220(160.38±36.77)min,术中出血量30~85(53.60±18.98)ml。2例术后出现轻度吞咽困难,给予雾化吸入等对症处理后均好转。CHE评分由术前(4.05±0.96)分降低至术后6个月的(2.40±0.70)分(t=12.97,P<0.05)。术后6个月38例眩晕改善,改善率90.5%。NDI评分的由术前的(34.43±8.04)分降低至术后6个月的(20.76±3.91)分(t=11.83,P<0.05)。颈椎曲度Cobb角由术前的(8.04±6.70)°提高至术后6个月的(12.42±5.23)°(t=-15.96,P<0.05)。结论:ACDF术式治疗椎动脉型颈椎病的临床疗效突出,手术通过解除骨性压迫,重建颈椎曲度,可快速缓解患者的发作性眩晕症状。但需要严格把握手术指征,明确患者眩晕原因,对保守治疗无效的CSA患者,ACDF手术可推荐使用。展开更多
文摘To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type （CSVAT） patients. Methods： In the present study, methods of evidence-based medicine, triple-centers, single-blindness, randomization and control were used. A total of 100 cases of CSVAT patients were randomized into acupuncture plus massage （acu-massage） group （n = 38）, acupuncture group （n = 32） and massage group （n = 30）. Acupoints used were Fengchi （风池, GB 20）, cervical Jiaji （颈夹脊 EX-B 2）, Baihui （百会 GV 20）, and the methods of massage used were kneading-rolling, adhesion-separating and acupoint-digital pressing, topical digital pressing and rubbing, traction-extending and mild palm-rubbing. The treatment was conducted once daily, with 7 sessions being a therapeutic course and continuously for 2 courses. Changes of peak velocity （Vp）, end-diastolic velocity （Vd）, mean velocity （Vm） of blood flow of the vertebral artery （VA） and basilar artery （BA）, etc were detected before and after the treatment by using transcranial Doppler （TCD） ultrasonography. Resuits： After the treatment, the abnormally low Vp of both VA and BA in acu-massage, acupuncture and massage groups, Vm of VA in acu-massage and acupuncture groups, Vm of BA in acu-massage and massage groups, and Vd of VA and BA in the 3 groups all increased significantly in comparison with their own pretreatment（ P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group in the 3 indexes were significantly superior to those of acupuncture group and/or massage group （P 〈0.05, 0.01 ）. The abnormally increased Vp of VA in acu-massage and acupuncture groups, Vm of VA in the 3 groups, and Vd of VA in acu-massage and massage groups decreased obviously after the treatment in comparison with their own pretreatment （P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group were significantly superior to those of acupuncture and/or massage group in the 3 indexes of VA （P〈0.05, 0.01）. In addition, the abnormally increased Vp, Vm and Vd of BA in the 3 groups showed a similar tendency. No significant differences between acupuncture and massage groups in 3 indexes （ P 〉0.05）. Conclusion： The therapeutic effects of acupuncture plus massage is significantly superior to those of simple acupuncture and simple massage therapies in improving abnormal blood dynamics of vertebral and basilar arteries in CSVAT patients.
文摘Cervical spondylosis of vertebral artery type is one of the chief patterns of cervical spondylosis.It is often described as neck pain accompanied with radiating pain and neurologic symptoms,such as sudden dizziness,blurred vision,tinnitus,nausea,vomiting,memory loss,and sudden fainting.The incidence of cervical spondylosis increases and patients with cervical spondylosis become progressively younger.Acupuncture in the cervical spondylosis of vertebral artery type treatment has a local positive reaction“Liuhe point”,in order to dredge the local Qi and blood.More and more evidences into the effectiveness and safety of cervical spine acupuncture for cervical spondylosis,specific neck pain,cervical radiculopathy,etc.This article summarizes the recent literature on acupuncture and acupuncture combined with other therapies for cervical spondylosis of vertebral artery type treatment and provides a comprehensive review from the perspectives of acupuncture therapy,warm needle moxibustion therapy,electroacupuncture,and acupuncture combined with other therapies,in order to provide reference and reference for clinical treatment.
文摘Objective.To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis （VACS）. Methods： In the present study, triple-center, single-blind, randomized and control methods were adopted. Qualified subjects were randomly assigned to three groups： acupuncture-massage （acu-mas） group, acupuncture group, and massage group （60 subjects in each group）. Bilateral Fengchi （风池 GB 20）, Jiaji （夹脊 EX-B 2, C4-7） and Baihui （百会 GV 20） ware punctured in combination with massage at the neck-shoulder and back region. The treatment was conducted once daily, 14 times altogether. Results. After treatment, of the 60 cases in each of acu-mas, acupuncture and massage groups, 28, 11 and 13 were cured, 13, 20 and 17 markedly effective, 12, 14 and 16 effective, and 7, 15 and 14 ineffective, with the total effective rates being 88.3%, 75.0% and 76.7% respectively. The therapeutic effect of acu-mas group was significantly superior to that of simple acupuncture and massage groups （P〈 0.05）. The scores of clinical symptoms and signs in 3 groups all declined significantly after treatment （ P〈 0.01 ）, and the score of symptoms of acu-mas was markedly lower than those of acupuncture and massage groups （P〈 0.05）. No significant differences were found among 3 groups in the score of clinical signs and between acupuncture and massage groups in the score of clinical symptoms （P〉0.05）. The time for producing therapeutic effects in acu-mas group was significantly shorter than those of acupuncture and massage groups （P〈0.01, 0.05）, meanng a faster of aou-mas group in producing clinical effect. No adverse events ware found in all the 3 groups. Conclusion： Acupuncture and massage are effective and safe in the treatment of VACS, and the therapeutic effect of acupuncture combined with massage is superior to that of simple acupuncture and simple massage therapy.
文摘we studied 30 vertebral arterial insufficiency type cervical spondylosis patients and 30sex and age matched healthy controls by detecting their serum endothelin (ET) levels with radioimmuuoassay (RIA).At the same time, we selected 20 severe patients for operation therapy,and compared their serum ET levels before and after operation.The results showed that 30 patients had higher ET levels [(119. 46±58.65)ng/L] than those of the controls [(38. 43±14.33)ng/L], and the 20 patients had higher ET levels before operation [(139. 34±52. 56)ng/L] than after operation [(50.84±21. 67)ng/L)].Both have statistical significance (P<0.001 ).Therefore, we think that serum ET is one or important humoral factors contributing to vertebral arterial insufficiency type cervical spondylosis.It may be useful in treating verteibral arterial insufficiency type cervical spondylosis with effective ET-antibody, inhibitor or ET converting enzyme and special ET receptor blocker.
文摘Objective To compare the differences in the efficacy on cervical spondylosis of the vertebral artery type （CSA） treated with the warm needling therapy combined with the rehabilitation physiotherapy, the simple warm needling therapy and the simple rehabilitation physiotherapy separately and observe the impacts of them on the vertebral basilar artery （VBA） in hemodynamics. Methods Ninety cases of CSA patients were randomized divided into an acupuncture plus rehabilitation group, a warm needling group and a rehabilitation group, 30 cases in each. In the acupuncture ＋ rehabilitation group, the warm needling therapy was used at Jiájǐ （夹脊 EX-B 2） from C3 to C7 in combination with the rehabilitation physiotherapy such as traction and magnetic therapy. In the warm needling group, the simple warm needling therapy was applied. In the rehabilitation group, the simple rehabilitation physiotherapy was adopted. The VBA hemodynamic parameters, Vp, Vd, Vm and PI values were detected under the transcranial Doppler and taken as the indexes for the efficacy assessment of the groups. The efficacy of each group was assessed in association with the clinical curative rate. Results After treatment, the VBA hemodynamic parameters, Vp, Vd, Vm and PI values were all remarkably improved as compared with those before treatment in the three groups （P〈0.01, P〈0.05）. The improvement of the indexes in the acupuncture plus rehabilitation group were more significant as compared with either of the other two groups （all P〈0.01）. The clinical curative rate was 70.0% （21/30） in the acupuncture plus rehabilitation group, which was superior to 53.3% （16/30） in the warm needling group and 53.3% （16/30） in the rehabilitation group （all P〈0.01）. Conclusion The warm needling in combination with the rehabilitation physiotherapy significantly improves in VBA hemodynamic parameters for CSA and its clinical efficacy is superior to either the simple warm needling or the rehabilitation physiotherapy. Hence, this combined therapy was highly deserved to be promoted in clinical practice.
基金Supported by the Fund of Capital Medical Development and Research(No.Ⅲ-11)the Subject Growth Fund of Guang'anmen Hospital,China Academy of Chinese Medical Sciences(No.81392)
文摘OBJECTIVE:To determine the clinical effect,treatment times,and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations.METHODS:One hundred and twenty six cervical spondylosis patients(vertebral artery type) were randomly divided into test and control groups.Patients in the test group were treated with innovative Tuina manipulations,while those in the control group were treated with the routine Tuina manipulations according to the textbook of Chinese Massage for Acupuncture and Moxibustion majors.The clinical effects,treatment times,clinical symptoms,and cerebral blood flow were measured.RESULTS:The response to the treatment was 100% in the test group and 88.71% in the control group.Patients in the test group required(7 ± 4) treatments before recovery,while those in the control group required(15 ± 7) treatments before recovery(P<0.05).The clinical symptoms exhibited greater improvement in the test group compared to the control group(P<0.05).There were no differences in cerebral blood flow between the two groups.CONCLUSION:Both innovative Tuina manipulations and routine Tuina manipulations produced satisfactory therapeutic results in vertebral artery type cervical spondylosis patients.However,the innovative manipulation was more effective in improving the functional symptoms,although there were no changes in the cerebral blood flow.
文摘Objective To verify the clinical efficacy of the filiform-fire needling therapy on cervical spondylosis of vertebral artery type（CSA）.Methods One hundred and twenty cases of CSA were treated with the filiform-fire needling therapy.The acupoints were Bǎihuì（百会 GV 20）,Fēngchí（风池 GB 20）,Nǎohù（脑户 GV 17）,Jìngbǎiláo（颈百劳 EX-HN 15）,etc.The needles were inserted rapidly and retained for 20 min.The treatment was given once a day.7 treatments made 1 session.The efficacy was assessed after 1 session of treatment.Results Eighty-eight cases were effective markedly,accounting for 73.3%.Twenty-seven cases were effective,accounting for 22.4%.Five cases were failed,accounting for 4.2%.The total effective rate was 95.8%.Conclusion The filiform-fire needling therapy achieves the significant efficacy on CSA.
文摘目的:探讨颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的临床效果。方法:回顾性分析2020年1月至2022年1月42例CSA患者的临床资料,男25例,女17例;年龄30~74(53.9±11.0)岁。单节段病变18例,2个节段病变17例,3个节段病变7例。分别在术前和术后6个月时采用美国耳鼻咽喉头颈外科学会听力及平衡委员会评分(Committee on Hearing and Equilibrium,CHE)、颈椎功能障碍指数(neck disability index,NDI)和颈椎曲度Cobb角进行临床疗效评价。结果:42例患者均获随访,随访时间6~30(14.0±5.2)个月;手术时间95~220(160.38±36.77)min,术中出血量30~85(53.60±18.98)ml。2例术后出现轻度吞咽困难,给予雾化吸入等对症处理后均好转。CHE评分由术前(4.05±0.96)分降低至术后6个月的(2.40±0.70)分(t=12.97,P<0.05)。术后6个月38例眩晕改善,改善率90.5%。NDI评分的由术前的(34.43±8.04)分降低至术后6个月的(20.76±3.91)分(t=11.83,P<0.05)。颈椎曲度Cobb角由术前的(8.04±6.70)°提高至术后6个月的(12.42±5.23)°(t=-15.96,P<0.05)。结论:ACDF术式治疗椎动脉型颈椎病的临床疗效突出,手术通过解除骨性压迫,重建颈椎曲度,可快速缓解患者的发作性眩晕症状。但需要严格把握手术指征,明确患者眩晕原因,对保守治疗无效的CSA患者,ACDF手术可推荐使用。
