摘要
目的:探讨颈前路椎间减压融合(anterior cervical decompression and fusion,ACDF)技术与颈人工间盘置换术(cervical artificial disc replacement,CADR)的临床疗效及适应证。方法:选取2009年6月至2015年6月收治的100例颈椎病患者进行回顾性分析,男53例,女47例;年龄38~70岁。其中50例采取ACDF治疗(ACDF组),随访时间22~42(32.24±5.20)个月;50例采取CADR治疗(CADR组),随访时间23~48(30.40±5.66)个月。采用Odom标准评价两组患者临床疗效,采用JOA(17评分法)从感觉功能、运动功能、膀胱功能3个方面评估患者的脊髓功能状态,根据影像学资料对两组患者手术前后的椎间高度和颈椎曲度进行比较。结果:术后伤口愈合情况良好,无严重并发症发生。按照Odom评定标准,ACDF组优30例,良12例,可8例;CADR组优34例,良10例,可6例。两组临床疗效差异无统计学意义(u=4.000,P=0.827)。末次随访时两组患者的感觉、运动功能评分明显改善(P<0.05),膀胱功能评分改善不明显(P>0.05),CADR组感觉、运动功能评分较ACDF组改善更明显(P<0.05)。两组患者术前椎间高度、颈椎曲度差异无统计学意义,末次随访均有不同程度的恢复,但是CADR组恢复更明显。结论:CADR能够实现颈椎早期稳定,早期活动。在恢复颈椎生理曲度,改善感觉、运动功能上具有一定的优势,但是并不能够完全替代ACDF。
Objective：To compare the clinical effects and clinical indications between Mobi-C cervical artificial disc replacement（CADR） and MC＋ anterior cervical decompression and fusion（ACDF） in treating cervical spondylosis. Methods：The clinical data of 100 patients with cervical spondylosis treated ACDF or CADR from June 2009 to June 2015 were retrospectively analyzed. There were 53 males and 47 females,aged from 38 to 70 years old. Among them,50 cases were treated by ACDF（ACDF group）,follow up time was for 22 to 42 months with an average of（32.24±5.20） months;other 50 cases were treated by CADR（CADR group）,follow up time was for 23 to 48 months with an average of（30.40±5.66） months. Odom criterion was used to evaluate the clinical effects in two groups. JOA score,including sensory function,motor function and bladder function was used to assess the spinal cord function. Preoperative and postoperative responsible intervertebral space heights,cervical curvatures were compared by image data between two groups. Results：All incisions obtained good healing and no serious complications were found. At final follow up,30 cases got excellent results,12 good,8 fair in ACDF group;and 34 cases got excellent results,10 good,6 fair in CADR group;there was no significant difference between two groups（u =4.000,P =0.827）. At final follow up,the scores of sensory function and motor function were obviously improved（P〈0.05）,and bladder function had not obviously recovered（P〉 0.05） in two groups;and CADR group in the scores of sensory function and motor function were obviously better than of ACDF group（P〈0.05）. There was no significant difference in preoperative intervertebral space height,cervical curvature between two groups,and at final follow up both had different recovered. The recovery of CADR group was obviously better than of ACDF group. Conclusion：CADR can quickly recover normal action for patients and retains the movement. CADR has certain advantages in recovering cervical cu
作者
李思维
谭跃龙
李剑
吕文军
张德龙
胡乃严
李吉涛
王洪振
陈林林
LI Si-wei;TAN Yue-long;LI Jian;LYU Wen-jun;ZHANG De-long;HU Nai-ycaz;LI Ji-tao;WANG Hong-zhen;and CHEN-Lin-lin(Department of Orthopaedics,A nshan Iron and Steel Group General Hospital,Anshah 114003,Liaoning,China)
出处
《中国骨伤》
CAS
2018年第8期723-728,共6页
China Journal of Orthopaedics and Traumatology
关键词
颈椎病
减压术
脊柱融合术
颈人工间盘
Cervical spondylosis
Decompression
Spinal fhsion
Cervical ar6ficial disc
