张幸, 赵兴辉, 陈锐. 双小切口ACDF术治疗连续4节段脊髓型颈椎病的临床研究[J]. 蚌埠医学院学报, 2021, 46(10): 1443-1446. DOI: 10.13898/j.cnki.issn.1000-2200.2021.10.030
    引用本文: 张幸, 赵兴辉, 陈锐. 双小切口ACDF术治疗连续4节段脊髓型颈椎病的临床研究[J]. 蚌埠医学院学报, 2021, 46(10): 1443-1446. DOI: 10.13898/j.cnki.issn.1000-2200.2021.10.030
    ZHANG Xing, ZHAO Xing-hui, CHEN Rui. Clinical study of double small incision ACDF in the treatment of the continuous 4-level cervical spondylotic myelopathy[J]. Journal of Bengbu Medical College, 2021, 46(10): 1443-1446. DOI: 10.13898/j.cnki.issn.1000-2200.2021.10.030
    Citation: ZHANG Xing, ZHAO Xing-hui, CHEN Rui. Clinical study of double small incision ACDF in the treatment of the continuous 4-level cervical spondylotic myelopathy[J]. Journal of Bengbu Medical College, 2021, 46(10): 1443-1446. DOI: 10.13898/j.cnki.issn.1000-2200.2021.10.030

    双小切口ACDF术治疗连续4节段脊髓型颈椎病的临床研究

    Clinical study of double small incision ACDF in the treatment of the continuous 4-level cervical spondylotic myelopathy

    • 摘要:
      目的探讨双小切口颈前路椎间盘切除植骨融合术(ACDF)治疗连续4节段脊髓型颈椎病(CSM)的临床疗效。
      方法选取70例CSM病人,按照随机数字表法分为双小切口组与单切口组,分别采用双小切口与传统单切口ACDF术。记录2组病人手术完成情况及随访并发症发生率,比较术前、术后3个月、末次随访日本骨科协会(JOA)评分、颈椎总活动度(ROM)、颈椎功能残障指数(NDI)、疼痛视觉模拟评分(VAS)。
      结果2组手术时间、切口长度、出血量差异均无统计学意义(P>0.05);双小切口组并发症发生率明显低于单切口组(P < 0.01);2组病人各观察时间下VAS评分、颈椎ROM、NDI和JOA评分差异均无统计学意义(P>0.05);2组病人术前、术后3个月、末次随访VAS评分、颈椎ROM、NDI均逐渐降低(P < 0.01),2组JOA评分差异无统计学意义(P>0.05)。
      结论双小切口ACDF术治疗连续4节段CSM能获得与传统单切口手术一致的近期疗效,但双小切口ACDF术能够降低声音嘶哑、吞咽困难等颈前路手术并发症,具有一定的运用价值。

       

      Abstract:
      ObjectiveTo explore the clinical efficacy of double small incision anterior cervical discectomy and fusion(ACDF) in the treatment of continuous 4-level cervical spondylotic myelopathy(CSM).
      MethodsSeventy patients with CSM were divided into the double small incision group and single incision group according to the random number table method, and the double small incision group and single incision group were treated with the double small incision and traditional single incision ACDF, respectively.The surgical completion and follow-up complication rate in two groups were recorded, and the scores of the Japanese Orthopaedic Association(JOA), cervical total range of motion(ROM), cervical functional disability index(NDI) and visual analogue scale(VAS) were compared between two groups before surgery, after 3 months of surgery and at the last follow-up.
      ResultsThere was no statistical significance in the operation time, incision length and bleeding volume between two groups(P>0.05).The incidence rate of complications in double small incision group was lower than that in single incision group(P < 0.01).There was no statistical significance in the VAS score, cervical ROM, NDI and JOA score between two groups at each observation time(P>0.05).The VAS score, cervical ROM and NDI in two groups gradually decreased before surgery, after 3 months of surgery and at the last follow-up(P < 0.01), and there was no statistical significance in the JOA score between two groups(P>0.05).
      ConclusionsThe double small incision ACDF can achieve the same short-term efficacy as traditional single incision in the treatment of continuous 4-level CSM, but the double small incision ACDF can reduce the complications of anterior cervical surgery such as hoarse voice and dysphagia, which has certain application value.

       

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