摘要
目的对比分析经颈后肌间隙入路椎板成形术与正中入路椎板成形术治疗多节段颈椎脊髓病(multisegmental cervical spondylotic myelopathy,M-CSM)的临床效果。方法纳入2014年7月~2016年5月治疗的66例M-CSM患者进行研究,其中36例行经颈后肌间隙入路椎板成形术(观察组),30例行颈后正中入路椎板成形术(对照组),比较两组手术基本情况和临床疗效。结果与对照组相比,观察组手术时间明显延长,术中失血量明显增加,但轴性症状等并发症发生率明显降低(13.89% vs 40.00%),差异有统计学意义(P<0.05)。两组JOA评分、VAS评分分别于术后1周、3个月显著改善,但观察组术后JOA评分改善速度更明显(P<0.05)。两组术后3、12个月的颈椎曲度、颈椎活动度均显著改善,但观察组术后12个月颈椎曲度、颈椎活动度维持效果明显优于对照组(P<0.05)。结论经颈后肌间隙入路与正中入路行椎板成形术治疗M-CSM的临床效果相当,但前者并发症更少,且更有利于长期维持理想的颈椎曲度及活动度。
Objective To compare the clinical effect of posterior cervical spatium intermusculare approach and median approach laminoplasty for multi-segmental cervical spondylotic myelopathy (M-CSM). Methods From July 2014 to May 2016, 66 patients with M-CSM who were hospitalized and treated in the department of orthopedics of the hospital were selected retrospectively. Thirty-six patients were treated with posterior cervical spatium intermusculare approach laminoplasty (observation group), and 30 patients were treated with median approach laminoplasty (control group). The basic conditions of operation were compared between the two groups. The basic conditions and clinical effects of the two groups were compared. Results The operative time and intraoperative blood loss of the observation group were significantly shorter/less than those of the control group, but the incidence rate of complications such as axial symptoms of the observation group was significantly lower than that of the control group (13.89% vs 40.00%)(P<0.05). The JOA score and VAS score of the two groups were improved significantly at 1 week and 3 months after operation, but the JOA score of the observation group was improved more rapidly after operation(P<0.05). The cervical curvature and cervical mobility of the two groups were improved significantly at 3 and 12 months after operation, but the effect of maintaining cervical curvature and cervical mobility of the observation group was better than that of the control group at 12 months after operation(P<0.05). Conclusion The clinical effect of posterior cervical spatium intermusculare approach and median approach laminoplasty is similar in the treatment of M-CSM, but the complications of the former are fewer. The former is more conducive to the long-term maintenance of ideal cervical curvature and range of motion.
作者
秦超
QIN Chao(Department of Orthopedics, Nanyang Hospital of Traditional Chinese Medicine, Nanyang, Henan, 473000, China)
出处
《颈腰痛杂志》
2019年第3期356-358,共3页
The Journal of Cervicodynia and Lumbodynia
关键词
经颈后肌间隙入路
正中入路
椎板成形术
多节段颈椎脊髓病
posterior cervical spatium intermusculareapproach
median approach
laminoplasty
multi-segmentalcervical spondylotic myelopathy
