本文選題：多節(jié)段頸椎病 + 椎間盤切除�。� 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的對比分析頸前路椎間盤切除植骨融合術(shù)(ACDF)和椎體次全切除減壓植骨融合術(shù)(ACCF)兩種術(shù)式治療多節(jié)段頸椎病的臨床療效。方法對2014年3月到2015年3月該院收治的單節(jié)段頸椎病患者的臨床資料及影像學(xué)資料進行回顧性研究,符合要求的病歷共26例,其中13例行頸前路椎間盤切除植骨融合術(shù)(ACDF),13例行頸前路椎間盤切除植骨融合術(shù)(ACCF)。統(tǒng)計兩組的手術(shù)時間、術(shù)中出血量、住院時間、椎間高度的丟失、Cobb角的丟失以及對吞咽困難的發(fā)生率、植骨融合率,術(shù)前和術(shù)后3月、6月、12月VAS評分、NDI評分、JOA評分進行比較。結(jié)果所有患者均隨訪12個月,ACDF組在手術(shù)時間、術(shù)中出血量、平均住院日,椎間高度的丟失、Cobb角的丟失均優(yōu)于ACCF組(P0.05),兩組在術(shù)后均出現(xiàn)了不同程度的吞咽困難,但術(shù)后6月癥狀均消失;兩組術(shù)后VAS評分、NDI評分、JOA評分、融合率無明顯差異(P0.05)。結(jié)論兩種手術(shù)方式治療多節(jié)段頸椎病都能獲得滿意的臨床效果,ACDF具有手術(shù)時間短、出血量少、住院時間短等優(yōu)點,但ACDF并不能完全替代ACCF,手術(shù)方式需根據(jù)患者的具體情況而定。
[Abstract]:Objective to compare the clinical effects of anterior cervical disc resection and bone graft fusion (ACDF) and subtotal decompression and bone graft fusion (ACCF) in the treatment of multilevel cervical spondylosis. Methods from March 2014 to March 2015, the clinical and imaging data of patients with single-level cervical spondylosis were retrospectively studied. Anterior cervical discectomy and bone graft fusion were performed in 13 cases and anterior cervical discectomy and bone graft fusion were performed in 13 cases. The operation time, intraoperative bleeding volume, hospitalization time, loss of intervertebral height loss of Cobb angle, incidence of dysphagia, bone graft fusion rate, preoperative and postoperative 3 months, 6 months and 12 months after operation were compared between the two groups. Results all the patients were followed up for 12 months. The time of operation, the amount of blood lost during operation, the average days of hospitalization and the loss of Cobb angle of intervertebral height in ACDF group were better than those in ACCF group (P 0.05). The dysphagia occurred in different degree after operation in both groups. However, the symptoms disappeared at 6 months after operation, and there was no significant difference in the fusion rate between the two groups in terms of VAS score and VAS score and JOA score. Conclusion both of the two surgical methods can obtain satisfactory clinical results in the treatment of multilevel cervical spondylopathy. ACDF has the advantages of short operative time, less bleeding, and short hospitalization time. However, ACDF is not a complete substitute for ACCF, and the operation method should be determined according to the specific conditions of the patients.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3

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