發(fā)布時間：2018-12-20 06:35

【摘要】：背景：盡管經(jīng)前路頸椎減壓融合術(shù)被認(rèn)為是治療有癥狀頸椎病的標(biāo)準(zhǔn)手術(shù)方法,但是它常常會加速鄰椎病的發(fā)生。頸椎間盤置換術(shù)是一項(xiàng)能維持頸椎運(yùn)動功能的手術(shù)方法,被認(rèn)為是頸椎減壓融合術(shù)的替代方法。但是頸椎間盤置換術(shù)是否優(yōu)于頸椎減壓融合術(shù)還沒有明確的結(jié)論。 方法：我們檢索了PubMed、EMBASE、Medline和Cochrane Library中2014年12月12日前關(guān)于經(jīng)前路頸椎減壓融合術(shù)和頸椎間盤置換術(shù)的隨機(jī)對照研究,并且根據(jù)隨訪時間分為短期組和中期組。 結(jié)果：19篇隨機(jī)對照研究合計4516例患者被納入本研究。相對于術(shù)后早期來說,頸椎間盤置換術(shù)功能恢復(fù)更好(包括頸椎功能障礙指數(shù),頸椎功能障礙改善率,神經(jīng)功能改善率,頸痛NRS評分,疼痛VAS評分,全面改善率),手術(shù)節(jié)段活動度更大,并發(fā)癥和再次手術(shù)率更低(P0.05)。但是SF-36評分和鄰近節(jié)段活動度未見明顯差異(P0.05)。術(shù)后中期,頸椎間盤置換術(shù)在頸椎功能障礙指數(shù),神經(jīng)功能改善率,疼痛NRS評分和手術(shù)節(jié)段再次手術(shù)率均優(yōu)于融合術(shù)(P0.05),而鄰近節(jié)段二次手術(shù)率未見明顯差異(P0.05)。 結(jié)論：頸椎間盤置換術(shù)有更好的功能恢復(fù),更少的并發(fā)癥和再次手術(shù)率。不論是在安全性還是有效性上均優(yōu)于融合術(shù)。但是兩者的長期效果還需要更多的長期隨訪的多中心隨機(jī)對照研究。
[Abstract]:Background: although anterior cervical decompression and fusion is considered to be the standard procedure for the treatment of symptomatic cervical spondylosis, it often accelerates the onset of adjacent spondylosis. Cervical disc replacement is a method to maintain cervical motor function and is considered to be an alternative to cervical decompression and fusion. But there is no clear conclusion whether cervical disc replacement is superior to cervical decompression and fusion. Methods: we searched the randomized controlled study of anterior cervical decompression and fusion and cervical disc replacement in PubMed,EMBASE,Medline and Cochrane Library before December 12, 2014, and were divided into two groups according to the follow-up time. Results: a total of 4516 patients in 19 randomized controlled trials were included in this study. The recovery of cervical disc replacement function was better than early postoperative (including cervical spine dysfunction index, cervical spine dysfunction improvement rate, neural function improvement rate, cervical pain NRS score, pain VAS score, overall improvement rate). The level of motion was higher, the complications and the rate of reoperation were lower (P0.05). However, there was no significant difference between SF-36 score and adjacent segment activity (P0.05). In the middle stage of operation, cervical intervertebral disc replacement was superior to fusion in cervical dysfunction index, neural function improvement rate, pain NRS score and reoperation rate of surgical segment (P0.05). There was no significant difference in the rate of secondary operation in adjacent segments (P0.05). Conclusion: cervical disc replacement has better functional recovery, fewer complications and reoperation rate. It is superior to fusion in safety and effectiveness. But their long-term effects require more long-term follow-up multicenter randomized controlled trials.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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相關(guān)期刊論文 前2條

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本文編號：2387584