CAJ | 학술논문

[目的]对比研究Mobi-C人工颈椎间盘置换术与经颈椎前路减压植骨融合术治疗脊髓型颈椎病的治疗效果。[方法]自2008年2月至2012年2月收治的59例脊髓型颈椎病手术的病例，其中29例行M o-bi-C人工颈椎间盘置换术（试验组），30例行经颈前路减压植骨融合术（对照组）。比较并评价两组手术时间、术中出血量等指标；两组患者术前、术后3、12个月时JO A评分，颈椎活动度及临床疗效。[结果]试验组手术时间及出血量均明显低于对照组（ P ＜0．05）。随访1～5年，平均18个月，两组术后12个月JO A评分均较术前明显提高（ P ＜0．05），两组差异无统计学意义（ P ＞0．05）。试验组术后12个月RO M 较术前无显著改变（ P ＞0．05），对照组术后12个月ROM 较术前减小（ P ＜0．05），且显著小于试验组（ P ＜0．01）。两组患者Odom评定满意率无差异（ P＞0．05）。两组术后均未出现严重并发症。[结果]Mobi-C人工颈椎间盘置换术与经颈椎前路减压植骨融合术治疗脊髓型颈椎病早、中期均取得满意的临床疗效，然而 Mobi-C人工颈椎间盘置换术手术时间短、术中出血量少，并能有效保留颈椎活动度。
[목적]대비연구Mobi-C인공경추간반치환술여경경추전로감압식골융합술치료척수형경추병적치료효과。[방법]자2008년2월지2012년2월수치적59례척수형경추병수술적병례，기중29례행M o-bi-C인공경추간반치환술（시험조），30례행경경전로감압식골융합술（대조조）。비교병평개량조수술시간、술중출혈량등지표；량조환자술전、술후3、12개월시JO A평분，경추활동도급림상료효。[결과]시험조수술시간급출혈량균명현저우대조조（ P ＜0．05）。수방1～5년，평균18개월，량조술후12개월JO A평분균교술전명현제고（ P ＜0．05），량조차이무통계학의의（ P ＞0．05）。시험조술후12개월RO M 교술전무현저개변（ P ＞0．05），대조조술후12개월ROM 교술전감소（ P ＜0．05），차현저소우시험조（ P ＜0．01）。량조환자Odom평정만의솔무차이（ P＞0．05）。량조술후균미출현엄중병발증。[결과]Mobi-C인공경추간반치환술여경경추전로감압식골융합술치료척수형경추병조、중기균취득만의적림상료효，연이 Mobi-C인공경추간반치환술수술시간단、술중출혈량소，병능유효보류경추활동도。
[Objective] To compare the efficacy of Mobi-C artificial cervical disc replacement vs anterior cervical decompression bone fusion in the treatment of cervical spondylotic myelopathy (CSM ) .[Methods] A total of 59 patients with CSM treated from Feb .2008 to Feb .2012 included 29 patients undergoing Mobi-C ar-tificial cervical disc replacement (experimental group) and 30 patients undergoing anterior cervical decompres-sion bone fusion(control group) .The operation time and blood loss of the two groups were compared and eval-uated .Japanese orthopedic association(JOA) score and range of movement(ROM) of cervical vertebrae before surgery ,3 months and 12 months after surgery and the clinical outcome were assessed .[Results]The operation time and blood loss in experimental group were obviously lower than those in control group ( P <0 .05) .Fol-low-up time ranged from 1 to 5 years with mean 18 months .Compared with before surgery ,the JOA score 12 months after surgery of the two groups were obviously improved ( P < 0 .05) ,but there was no significant difference between the two groups( P>0 .05) .Compared with before surgery ,ROM in experimental group 12 months after surgery had no change( P>0 .05) ,but the ROM in control group 12 months after surgery was decreased( P <0 .05) and significantly smaller than that in experimental group( P<0 .01) .There was no sig-nificant difference in Odom rating satisfactory rate between two groups ( P >0 .05) .No serious complication occurred in two groups after surgery .[Conclusion]Both Mobi-C artificial cervical disc replacement and anteri-or cervical decompression bone fusion for the treatment of cervical spondylotic myelopathy at early and middle stage can obtain favorable clinical outcomes .However ,Mobi-C artificial cervical disc replacement has short operation time and little blood lose ,and can maintain cervical ROM effectively .