CAJ | 학술논문

目的探讨单节段颈椎前路减压融合术对邻近节段退变的影响及手术疗效.方法回顾性分析2007年8月~2010年12月我科收治的40例行单节段颈椎前路减压融合术患者及同期同年龄段颈椎病(影像学显示仅单节段病变)且行保守治疗的患者资料.采用椎间隙高度及椎间盘Pfirrmann MRI退变评分作为评价椎间盘退变指标;采用颈椎JOA评分、颈椎功能障碍指数(NDI)作为手术疗效评价指标.结果术后24个月时,与对照组相比,手术组邻近节段椎间隙高度明显降低,差异有统计学意义(P<0.05);椎间盘退变Pfirrmann MRI评分明显增高,差异有统计学意义(P<0.05).与术前相比,手术组患者在术后1周及24个月时颈椎JOA评分明显升高且NDI明显降低,差异有统计学意义(P<0.05);术后24个月与术后1周相比,颈椎JOA评分及NDI差异无统计学意义(P>0.05).结论颈椎前路减压融合术后邻近节段易发生退变,但疗效值得肯定.
목적탐토단절단경추전로감압융합술대린근절단퇴변적영향급수술료효.방법회고성분석2007년8월~2010년12월아과수치적40례행단절단경추전로감압융합술환자급동기동년령단경추병(영상학현시부단절단병변)차행보수치료적환자자료.채용추간극고도급추간반Pfirrmann MRI퇴변평분작위평개추간반퇴변지표;채용경추JOA평분、경추공능장애지수(NDI)작위수술료효평개지표.결과술후24개월시,여대조조상비,수술조린근절단추간극고도명현강저,차이유통계학의의(P<0.05);추간반퇴변Pfirrmann MRI평분명현증고,차이유통계학의의(P<0.05).여술전상비,수술조환자재술후1주급24개월시경추JOA평분명현승고차NDI명현강저,차이유통계학의의(P<0.05);술후24개월여술후1주상비,경추JOA평분급NDI차이무통계학의의(P>0.05).결론경추전로감압융합술후린근절단역발생퇴변,단료효치득긍정.
Objective To evaluate the clinical effectiveness and influence on adjacent segments degenera-tion after single-level anterior cervical fusion.Methods A retrospective study was given to 40 patients who underwent single-level anterior cervical fusion from Aug.2007 to Dec.2010 and 40 patients with cervical spondylosis of the same age for the same period(imaging showed only a single segment lesions ) underwent conservative therapypatient .The disc degeneration were evaluated using intervertebral disc height and disc Pfirrmann MRI degeneration score .The clinical ef-fectiveness were evaluated using cervical JOA score ,the neck disability index(NDI) .Results The surgical group and conservative group had a statistically significant difference (P<0.05) in intervertebral disc height and disc Pfirrmann MRI score at 24 months after surgery.Patients after surgery had statistically significant (P<0.05) in cervical JOA score and NDI compared with preoperation.Twenty-four months after surgery had no significant difference (P>0.05) in cervi-cal JOA score and NDI than 1 week after that.Conclusion Anterior cervical discectomy and fusion can lead to degener-ation at the adjacent segment,but the clinical effectiveness are worthy of recognition .