CAJ | 학술논문

目的：探讨颈椎解剖学测量在颈椎前路减压手术中的应用价值。方法120例脊髓颈椎病患者，按随机数字表法分为研究组和对照组，每组60例。术前测量18具成年人颈椎标本C3～C7相关数据：横突孔间距离、钩突尖间距、双侧钩突后缘间距离、双侧钩突前缘间距、钩突前后径、椎管横径、椎体矢状径。研究组根据上述解剖学测量结果施行椎体前路减压手术，对照组按常规方法施行椎体前路减压手术。比较两组的手术疗效、手术时间及术中出血量。结果 C3～C7椎体钩突后缘间距离比较，差异无统计学意义（P＞0．05）；C3～C7双侧钩突前缘间距离、颈椎管最大横径比较，差异有统计学意义（P＜0．05），呈逐渐增大趋势。两组患者均顺利完成椎体前路减压手术，两组手术时间、出血量比较，差异无统计学意义（P＞0．05）；术后6个月，研究组JOA评分明显高于对照组（P＜0．05）。结论使用颈椎解剖学测量数据施行颈椎前路减压手术效果更好。
목적：탐토경추해부학측량재경추전로감압수술중적응용개치。방법120례척수경추병환자，안수궤수자표법분위연구조화대조조，매조60례。술전측량18구성년인경추표본C3～C7상관수거：횡돌공간거리、구돌첨간거、쌍측구돌후연간거리、쌍측구돌전연간거、구돌전후경、추관횡경、추체시상경。연구조근거상술해부학측량결과시행추체전로감압수술，대조조안상규방법시행추체전로감압수술。비교량조적수술료효、수술시간급술중출혈량。결과 C3～C7추체구돌후연간거리비교，차이무통계학의의（P＞0．05）；C3～C7쌍측구돌전연간거리、경추관최대횡경비교，차이유통계학의의（P＜0．05），정축점증대추세。량조환자균순리완성추체전로감압수술，량조수술시간、출혈량비교，차이무통계학의의（P＞0．05）；술후6개월，연구조JOA평분명현고우대조조（P＜0．05）。결론사용경추해부학측량수거시행경추전로감압수술효과경호。
Objective To explore the value of anatomic measurement applied to anterior cervical decompression surgery.Methods One hundred and twenty patients with cervical spondylotic myelopathy were divided into research group and control group based on random number table,with 60 cases in each group.Eighteen specimens of adult vertebrae cervicales were measured and the related data of C3 -C7 were collected before the surgery.The data included the distance between the adjacent transverse foramina,the distance between adjacent tips of uncus of vertebral body,the distance between bilateral posterior margins of uncus of vertebral body,the distance between bilateral anterior margins of uncus of vertebral body,the anteroposterior diameter of uncus of vertebral body,spinal canal transverse diameter and vertebral sagittal diameter.The anterior cervical decompression surgery was performed in the research group according to the measurement results, while the routine anterior cervical decompression surgery was performed in the control group.The surgical efficacy,operative duration and intraoperative blood loss were compared between two groups.Results There was no significant difference in the distance between bilateral posterior margins of uncus of vertebral body among C3 -C7(P>0.05).There was significant difference in the distance between bilateral anterior margins of uncus of vertebral body and the maximum spinal canal diameter among C3 -C7(P<0.05),and the distance and the diameter increased gradually from C3 to C7 .The anterior cervical decompression surgeries were completed in all cases.There was no significant difference in the operative duration or blood loss between two groups(P>0.05).The JOA score of research group was significantly higher than that of control group 6 months after surgery(P<0.05).Conclusion The efficacy of anterior cervical decompression surgery is better when the data of cervical anatomical measurement are applied to the surgery.