摘要
目的分析比较前路椎体次全切除钛网植骨融合内固定术（ACCF）与前路椎间盘切除Cage植骨融合内固定术（ACDF）治疗相邻双节段脊髓型颈椎病的中期并发症发生情况。方法分析2011年1月至2014年12月期间共252例相邻双节段脊髓型颈椎病行颈前路减压融合内固定患者的临床资料。结果两组患者手术时间及术中出血量无明显差异（P〈0．05）；随访过程中，失访25例，其余均术后随访36个月。共有61例在术后36个月内出现并发症，发生率26．87％，其中ACCF组33例（包括吞咽不适2例，内固定相关并发症1例，邻近节段退变26例，融合失败1例，C5神经根麻痹3例）；ACDF组28例（伤口感染1例，吞咽不适1例，内固定相关并发症1例，邻近节段退变23例，融合失败1例，C5神经根麻痹1例）。结论在邻近双节段脊髓型颈椎病的治疗上，ACDF组并发症发生率略高（27．2％vs26．6％），但无明显统计学差异，而ACCF组C5神经根麻痹的发生率稍高。
Objective To analyze the midterm complications between the anterior cervical corpectomy and fusion （ ACCF ） and the anterior cervical discectomy and fusion （ ACDF ） for the treatment of adjacent bilateral segmental cervical spondylotic myelopathy. Methods The clinical data of 252 cases of adjacent bilateral cervical spondylotic myelopathy were analyzed retrospectively from January 2011 to December 2015. Results There was no significant difference between the two groups in operation time and intraoperative blood loss （P〈0.05） . During the follow-up, 25 cases were lost and the rest were followed up for 36 months. A total of 61 cases had complications during the follow-up after surgery, with an incidence of 26.87%. There were 33 cases in ACCF group, （ 2 case of swallowing discomfort, 1 cases of internal fixation related complications, 26 cases of adjacent segment degeneration, 1 case of fusion failure, 3 cases of C5 nerve root paralysis） , and 28 cases in ACDF group, （ 1 case of wound infection, 1 case of swallowing discomfort, 1 cases of internal fixation related complications, 23 cases of adjacent segment degeneration, 1 cases of fusion failure, 1 cases of C5 nerve root paralysis） . Conclusion For the treatment of adjacent bilateral cervical spondylotic myelopathy, the incidence of mid-term complications of ACDF group is 27.2%, and the ACCF group is 26.6%, there is no statistical difference. The incidence of C5 nerve root palsy is higher in ACCF group.
出处
《浙江临床医学》
2018年第8期1351-1352,1355,共3页
Zhejiang Clinical Medical Journal
基金
浙江省湖州市科技局项目（2017GYB24,2016GY43）
关键词
颈椎病
前路手术
钛网
并发症
Cervical spondylotic myelopathy
Anterior approach surgery
Titanium mesh
Compfication
