【摘要】：目的 分析探討一期前后路聯(lián)合手術(shù)(Combined anterior-posterior surgery, CAPS)治療前后受壓型多節(jié)段脊髓型頸椎病(Multilevel cervical spondylotic myelopathy, MCSM)的臨床療效、影像學(xué)效果及手術(shù)適應(yīng)癥。方法回顧性分析2010年1月至2014年1月我院采用一期前后路聯(lián)合手術(shù)治療的前后受壓型多節(jié)段脊髓型頸椎病53例病例資料。從臨床和影像學(xué)效果對(duì)手術(shù)療效進(jìn)行分析,觀察住院時(shí)間、手術(shù)時(shí)間、術(shù)中出血量、日本骨科協(xié)會(huì)頸椎病評(píng)分(Japanese orthopedic association scores, JOA)、頸椎功能障礙指數(shù)(The neck disability index, NDI)、頸椎總活動(dòng)度(Cervical range of motion, CROM)、頸椎曲度指數(shù)(Cervical curvature index, CCI)及手術(shù)并發(fā)癥發(fā)生率,結(jié)合國(guó)內(nèi)外學(xué)者的研究成果,分析探討一期前后路聯(lián)合手術(shù)治療前后受壓型多節(jié)段脊髓型頸椎病的手術(shù)療效和適應(yīng)癥。結(jié)果53例患者手術(shù)順利,2例患者隨訪時(shí)間不足1年而失訪,剩余51例中男性33例,女性18例,年齡為42-71歲,隨訪時(shí)間為12-36個(gè)月。平均住院時(shí)間為(16.18±3.49)天,平均手術(shù)時(shí)間(222.55±36.23)min,平均術(shù)中出血量(506.78±136.56)ml。術(shù)前JOA評(píng)分平均為(8.51±1.57)分,術(shù)后平均為(13.67±1.70)分,術(shù)后JOA評(píng)分提高顯著(P0.05),平均JOA改善率為(62.48±13.83)%；術(shù)前NDI評(píng)分平均為(38.10±4.14)分,術(shù)后平均為(21.39±3.97)分,術(shù)后NDI評(píng)分較術(shù)前降低(P0.05),NDI評(píng)分平均改善值為(16.65±3.70)分。術(shù)前CCI平均為(11.30±1.68)%,術(shù)后平均為(15.92±1.43)%,術(shù)后CCI提高(P0.05)；術(shù)前矢狀面CROM平均為(75.63±8.55)。,術(shù)后平均為(50.69±5.76)。,術(shù)后CROM減少(P0.05),術(shù)后CROM平均丟失(26.35±5.56)°。術(shù)后2例患者出現(xiàn)腦脊液漏,6例C5神經(jīng)麻痹,2例切口愈合不佳,8例吞咽疼痛,1例喉返神經(jīng)損傷,前方植骨均愈合良好,后方無(wú)再關(guān)門發(fā)生。結(jié)論一期前后路聯(lián)合手術(shù)治療前后受壓型多節(jié)段脊髓型頸椎病具有減壓充分、術(shù)后神經(jīng)功能改善和頸椎穩(wěn)定好的優(yōu)勢(shì),是一種較好的手術(shù)方式,但需要考慮其手術(shù)創(chuàng)傷大、術(shù)后頸椎活動(dòng)度丟失及并發(fā)癥較多的不足,需嚴(yán)格把握適應(yīng)癥。
[Abstract]:Objective to analyze the clinical efficacy, imaging effect and surgical indication of compression multisegmental cervical Spondylotic myelopathy (Multilevel cervical spondylotic myelopathy, MCSM) before and after one-stage anterior and posterior combined surgery (Combined anterior-posterior surgery, CAPS). Methods from January 2010 to January 2014, 53 cases of compression multisegmental cervical Spondylotic myelopathy were treated with one stage anterior and posterior combined surgery. The curative effect of operation was analyzed from clinical and imaging results, and the hospitalization time, operation time, intraoperative blood loss, cervical spondylosis score (Japanese orthopedic association scores, JOA), cervical dysfunction index (The neck disability index, NDI), cervical curvature index (Cervical curvature index, CCI) and the incidence of surgical complications were observed, combined with the research results of scholars at home and abroad. To analyze the curative effect and indication of compression multisegmental cervical Spondylotic myelopathy before and after one stage anterior and posterior combined surgery. Results the operation was smooth in 53 patients. The follow-up time of 2 patients was less than 1 year. The remaining 51 patients were 33 males and 18 females, aged 42 鈮，

本文編號(hào)：2506164