摘要
目的探讨后路单开门、一期前后路手术减压联合治疗前后受压脊髓型颈椎病患者的疗效分析。方法将2014年3月~2016年3月在我院骨科治疗的84例前后受压脊髓型颈椎病患者随机分为两组,对照组采用后路单开门手术治疗,观察组采用一期前后路手术减压联合治疗,比较两组患者的各项手术指标、脊椎功能恢复情况、并发症发生情况。结果观察组手术时间、术中出血量、椎管开门度数与对照组相比,两组有显著差异(P<0.05);术后6个月,根据日本矫形外科学会(JOA)评分,观察组神经功能改善率为74.3%,优良率为80.95%,对照组神经功能改善率为73.6%,优良率为78.57%,两组间无明显差异(P>0.05);观察组并发症发生率为9.52%,低于对照组的11.90%,两组间无统计学差异(P>0.05)。结论后路单开门与一期前后路手术减压联合治疗前后受压脊髓型颈椎病均有良好的效果,能够有效恢复颈椎生理弧度,使脊髓充分后移,解除前方压迫,应分清适应征采取相应的术式治疗。
Objective To explore analysis on curative effect of posterior single open-door operation and onestage anterior and posterior operation decompression combined treatment on patients with anterior and posterior compression cervical spondylotic myelopathy.Methods84patients with anterior and posterior compression cervical spondylotic myelopathy who were treated in department of orthopedics in our hospital from March2014to March2016were randomly divided into two rgoups.The control group was given posterior single open-door operation for treatment while the observation group was given one-stage anterior and posterior operation decompression combined treatment.Operation indexes,spinal functional recovery and occurrence of complications of patients in two groups were compared.Results Operation time,intraoperative blood loss,open-door degree of vertebral canal of two groups had significant difference(P<0.05).On6months after operation,improvement rate of neurological function in the observation group was74.3%and excellent and good rate was80.05%according to Japanese Orthopedic Association(JOA).Improvement rate of neurological function in the control group was74.3%and excellent and good rate was80.05%.There was no significant difference between two groups(P>0.05).Complication rate of the observation group was9.52%,lower than that of the control group11.90%.There was no significant difference between two groups(P>0.05).Conclusion Effects of posterior single open-door operation and one-stage anterior and posterior operation decompression combined treatment on patients with anterior and posterior compression cervical spondylotic myelopathy are both good,which can effectively recover cervical lordosis to push fully retrocession of spinal cord and release anterior compression.Patients should be given corresponding operation for treatment according to indications.
作者
王昊
蔡宏华
WANG Hao;CAI Honghua(Department of Spine Surgery, Huizhou Central People's Hospital, Guangdong, Huizhou 516000, China)
出处
《中国医药科学》
2017年第11期224-226,229,共4页
China Medicine And Pharmacy
关键词
前后受压脊髓型颈椎病
后路单开门
一期前后路手术减压联合治疗
Anterior and posterior compression cervical spondylotic myelopathy
Posterior single open-door
Onestage anterior and posterior operation decompression combined treatment
