中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2009年
35期
15-19
,共5页
王沫学%葛建杰%王金娜%毕国风
王沫學%葛建傑%王金娜%畢國風
왕말학%갈건걸%왕금나%필국풍
颈椎病%手术后并发症%联合手术
頸椎病%手術後併髮癥%聯閤手術
경추병%수술후병발증%연합수술
Cervical spondylosis%Postoperative complications%Joint surgery
目的 观察多节段脊髓型颈椎病行单纯前路或后路与后前路联合手术后的脊髓功能改善及预后状况,探讨后前路联合手术的临床疗效及并发症情况.方法 将2001年1月至2008年1月收治的298例多节段脊髓型颈椎病患者按手术方式分为三组:颈前路手术减压植骨钛网植入钛板内固定术121例(单纯前路手术组),后路单开门椎管扩大成形术112例(单纯后路手术组),后前路联合手术65例(后前路联合手术组).行脊髓功能日本骨科学会(JOA)评分、体感诱发电位检查,对比三组患者的术后疗效.结果 全部病例均获得1~7年随访,平均(4.7±1.4)年.单纯前路手术组改善率78.1%,优良率72.7%(88/121),单纯后路手术组改善率70.6%,优良率66.1%(74/112),两组比较差异有统计学意义(P<0.05).后前路联合手术组改善率86.7%,优良率83.1%(54/65),与单纯前路手术组、单纯后路手术组比较差异均有统计学意义(P<0.05).结论 在治疗多节段脊髓型颈椎病的手术中,后前路联合手术在疗效上明显优于单纯前路手术或单纯后路手术.脊柱稳定性单纯前路手术、单纯后路手术、后前路联合手术逐一降低.
目的 觀察多節段脊髓型頸椎病行單純前路或後路與後前路聯閤手術後的脊髓功能改善及預後狀況,探討後前路聯閤手術的臨床療效及併髮癥情況.方法 將2001年1月至2008年1月收治的298例多節段脊髓型頸椎病患者按手術方式分為三組:頸前路手術減壓植骨鈦網植入鈦闆內固定術121例(單純前路手術組),後路單開門椎管擴大成形術112例(單純後路手術組),後前路聯閤手術65例(後前路聯閤手術組).行脊髓功能日本骨科學會(JOA)評分、體感誘髮電位檢查,對比三組患者的術後療效.結果 全部病例均穫得1~7年隨訪,平均(4.7±1.4)年.單純前路手術組改善率78.1%,優良率72.7%(88/121),單純後路手術組改善率70.6%,優良率66.1%(74/112),兩組比較差異有統計學意義(P<0.05).後前路聯閤手術組改善率86.7%,優良率83.1%(54/65),與單純前路手術組、單純後路手術組比較差異均有統計學意義(P<0.05).結論 在治療多節段脊髓型頸椎病的手術中,後前路聯閤手術在療效上明顯優于單純前路手術或單純後路手術.脊柱穩定性單純前路手術、單純後路手術、後前路聯閤手術逐一降低.
목적 관찰다절단척수형경추병행단순전로혹후로여후전로연합수술후적척수공능개선급예후상황,탐토후전로연합수술적림상료효급병발증정황.방법 장2001년1월지2008년1월수치적298례다절단척수형경추병환자안수술방식분위삼조:경전로수술감압식골태망식입태판내고정술121례(단순전로수술조),후로단개문추관확대성형술112례(단순후로수술조),후전로연합수술65례(후전로연합수술조).행척수공능일본골과학회(JOA)평분、체감유발전위검사,대비삼조환자적술후료효.결과 전부병례균획득1~7년수방,평균(4.7±1.4)년.단순전로수술조개선솔78.1%,우량솔72.7%(88/121),단순후로수술조개선솔70.6%,우량솔66.1%(74/112),량조비교차이유통계학의의(P<0.05).후전로연합수술조개선솔86.7%,우량솔83.1%(54/65),여단순전로수술조、단순후로수술조비교차이균유통계학의의(P<0.05).결론 재치료다절단척수형경추병적수술중,후전로연합수술재료효상명현우우단순전로수술혹단순후로수술.척주은정성단순전로수술、단순후로수술、후전로연합수술축일강저.
Objective To observe the multi-segmental cervical spondylotic myelopathy with simple anterior or posterior joint pre-and post-operative prognosis of spinal cord function improved and the status, explore co-operation after the clinical efficacy and complications. Methods The clinical data of 298 cases of multi-segmental cervical spondylotic myelopathy with anterior or posterior of the simple pre-and post-joint surgery from January 2001 to January 2008 were retrospectively analyzed. The clinical efficacy, titanium anterior cervical decompression and fusion surgery net implanted titanium plate fixation 121 cases, posterior open-door laminoplasty 112 cases, 65 cases of combined surgery before and after. JOA score line of spinal cord function and somatosensory evoked potential, as compared 3 groups after surgical efficacy. Results All patients were followed-up 1- 7 years, averaged (4.7±1.4) years. The anterior cervical decompression and fusion surgery titanium mesh implanted titanium plate fixation to improve the rate was 78.1%, excellent and good rate was 72.7%(88/121). Posterior open-door laminoplasty to improve the rate was 70.6%, excellent and good rate was 66.1% (74/112), there was statistically significant between them (P < 0.05). After anterior surgery, improving rate was 86.7%, excellent and good rate was 83.1% (54/65). Anterior and posterior combined surgery before and after comparison was significant (P < 0.05), regardless of near-term results, long-term effects were better than that of anterior or posterior surgery. Conclusions The spinal cord in the treatment of multi-segmental operation of cervical spondylosis after anterior surgery is obviously superior to the efficacy of anterior or posterior surgery alone. Spinal stability anterior, posterior, after a joint operation before the lower one by one.