CAJ | 학술논문

　　目的通过观察分析前路颈椎间盘切除融合术（anterior cervical discectomy and fusion，ACDF）术后随访患者的影像学资料，探讨邻近节段病变的发生时间和发生率。方法分析2008年以来本科收治的94例施行 ACDF 手术并获得完整随访的患者，其中男性51例，女性43例；年龄28～70岁，平均50.5岁。融合节段：单节段42例，上节段30例，三节段22例。术前均常规行颈椎正、侧位 X 线、MRI 检查。术后评定患者神经功能恢复情况，根据 Kellgren 分级标准对临近节段颈椎间盘退变情况进行 X 线评价。结果94例患者随访时间12～45个月，平均随访时间为29.1月。术后患者神经功能改善明显，JOA 评分较术前提高5.8，改善率为64.3%，有效率为100%。临近节段颈椎间盘退变情况的 X 线评估显示，有19例发生临近节段的退变，其中12例有轻度退变表现，7例出现较严重退变表现，邻近节段退变发生率为20.2%。退变发生时间为术后5～40个月，平均为18.7±4.79个月。结论 ACDF 治疗颈椎间盘退行性疾病有良好的疗效，术后邻近节段发生退变时间为18.7±4.79月，随访29.1个月邻近节段退变发生率为20.2%。
　　목적통과관찰분석전로경추간반절제융합술（anterior cervical discectomy and fusion，ACDF）술후수방환자적영상학자료，탐토린근절단병변적발생시간화발생솔。방법분석2008년이래본과수치적94례시행 ACDF 수술병획득완정수방적환자，기중남성51례，녀성43례；년령28～70세，평균50.5세。융합절단：단절단42례，상절단30례，삼절단22례。술전균상규행경추정、측위 X 선、MRI 검사。술후평정환자신경공능회복정황，근거 Kellgren 분급표준대림근절단경추간반퇴변정황진행 X 선평개。결과94례환자수방시간12～45개월，평균수방시간위29.1월。술후환자신경공능개선명현，JOA 평분교술전제고5.8，개선솔위64.3%，유효솔위100%。림근절단경추간반퇴변정황적 X 선평고현시，유19례발생림근절단적퇴변，기중12례유경도퇴변표현，7례출현교엄중퇴변표현，린근절단퇴변발생솔위20.2%。퇴변발생시간위술후5～40개월，평균위18.7±4.79개월。결론 ACDF 치료경추간반퇴행성질병유량호적료효，술후린근절단발생퇴변시간위18.7±4.79월，수방29.1개월린근절단퇴변발생솔위20.2%。
Objective To study the clinical efficacy of anterior cervical discectomy and fusion(ACDF) for cervical spondylosis , also the rate and occurrence time of adjacent segment degeneration.Methods 94 cases (male: 51, female: 43, average age: 50.5, ranging from 28 to 70)of cervical spondylosis admitted to our department since 2008 were analyzed in this study.42 patients were performed with single-level ACDF, 30 patients with double-level ACDF,and 22 patients with three-level ACDF. The cervical anterior-posterior and lateral X-ray and MRI examination were performed before the operation.Neurological functional recovery was assessed after operation. X -ray was used to evaluate the degree of adjacent segment degeneration according to the Kellgren’s standard.Results All patients were followed up from 12 to 45 months with average of 29.1 months. Postoperative neurological function in patients was significantly improved, JOA score increased by 5.8 points on average, and the average improvement rate was 64.3% , the efficiency rate was 100%. X - ray evaluation results showed that the occurrence rate of adjacent segment degeneration was 20.2% ,with 12 cases of slight degeneration and 7 cases of severe degeneration.The occurrence time of adjacent segment degeneration was 18.7±4.79 months,ranging from 5 to 40months.Conclusion ACDF has a good efficacy against cervical spondylosis ,the occurrence time of adjacent segment degeneration is 18.7±4.79 months,and the rate of adjacent segment degeneration is 20.2%.