CAJ | 학술논문

目的：比较分析颈椎间盘置换术（ CADR ）与颈椎前路减压融合术（ ACDF ）对邻近节段退变情况的影响。方法回顾性分析2008年2月～2011年10月手术治疗的62名患者，根据术式不同，分为CADR组与ACDF组。采用颈椎JOA、NDI评分评价症状及神经功能，C2～7 Cobb角和手术相邻节段活动度评价颈椎活动范围及退变情况。结果与术前比较，末次随访时两组患者神经功能明显改善，组内差异有显著性（P＜0．05），但组间比较差异无显著性（P＞0．05）。与术前相比，末次随访时CADR组C2～7 Cobb角和手术相邻上、下节段活动度相近，差异无显著性（P＞0．05）；ACDF组内比较与两组间末次随访时比较C2～7 Cobb角和手术相邻上、下节段活动度，差异有显著性（ P＜0．05）。结论 CADR术后对邻近节段的退变影响较ACDF小。
목적：비교분석경추간반치환술（ CADR ）여경추전로감압융합술（ ACDF ）대린근절단퇴변정황적영향。방법회고성분석2008년2월～2011년10월수술치료적62명환자，근거술식불동，분위CADR조여ACDF조。채용경추JOA、NDI평분평개증상급신경공능，C2～7 Cobb각화수술상린절단활동도평개경추활동범위급퇴변정황。결과여술전비교，말차수방시량조환자신경공능명현개선，조내차이유현저성（P＜0．05），단조간비교차이무현저성（P＞0．05）。여술전상비，말차수방시CADR조C2～7 Cobb각화수술상린상、하절단활동도상근，차이무현저성（P＞0．05）；ACDF조내비교여량조간말차수방시비교C2～7 Cobb각화수술상린상、하절단활동도，차이유현저성（ P＜0．05）。결론 CADR술후대린근절단적퇴변영향교ACDF소。
Objective To compare CADR with ACDF on the influence of the adjacent segments degenera-tion.Methods From February 2008 to October 2010,a total of 62 cases of cervical spondylosis was retrospectively re-viewed.All the patients were divided into CADR group and ACDF group ,depending on different surgical methods .The symptoms and neurological function were evaluated by the cervical Japanese Orthopaedic Association ( JOA) Scores and neck disability index ( NDI ) .The Cobb angle of C 2~7 and the mobility of adjacent segments were valuated the cervical range of mobility and degeneration .Results Compared with the preoperation , the last follow-up neurological function significantly improved ,the difference was statistically significant ( P<0.05) ,but the difference between groups was insig-nificant ( P>0 .05 ) .At last follow-up Cobb angle of C 2~7 and the mobility of adjacent upper and lower segments in CADR group were similar to the preoperative ,there was no significant difference statistically (P>0.05).And there was significant difference statistically in ACDF group and between the groups ( P<0.05) .Conclusion CADR is less influ-ential on the adjacent segments degeneration postoperative .