摘要
[目的]探讨椎间撑开高度对颈椎前路融合临床结果的影响。[方法]回顾性分析2013~2017年行因颈椎病行单节段颈椎前路减压融合内固定术118例患者资料。根据术后椎间隙撑开高度将病例分为3组,原位组27例,撑开为基准高度的100%~110%;适度撑开组57例,撑开高度为基准高度的110%~130%;过度撑开组34例,撑开高度大于基准高度的130%。比较3组围手术期、随访与影像资料。[结果]所有患者均顺利完成手术,无麻醉及术中意外发生,共19例患者出现了术后并发症,但无严重不良后果。与术前相比,术后2年3组患者VAS、NDI评分均显著降低(P<0.05);而JOA评分显著增加(P<0.05);术后2年适度撑开组患者JOA评分高于原位组和过度撑开组(P<0.05),而3组间VAS评分和NDI评分的差异均无统计学意义(P>0.05)。影像方面,术后2年过度撑开组无论是近侧或远侧相邻节段椎间高度丢失率均显著大于原位组和适度撑开组(P<0.05)。术后2年适度撑开组、过度撑开组颈椎前凸角均显著大于原位组(P<0.05)。[结论]椎间撑开高度的确影响颈椎前路融合的临床效果,本研究建议选择110%-130%的高度撑开。
[Objective]To explore the effect of intervertebral distraction height on the clinical outcomes of anterior cervical discectomy and fusion(ACDF).[Methods]A retrospective study was conducted on 118 patients who received ACDF for cervical myeloradiculopathy from 2013 to 2017 in our hospital.Based on intervertebral distraction height measured on radiographs postoperatively,27 patients got fu⁃sion in situ with distraction of 100%~110%of the original intervertebral height,57 patients had moderate distraction with distraction of 110%~130%and 34 patients got over distraction with distraction more than 130%.The perioperative,follow-up and radiological data were compared among the 3 groups.[Results]All the patients recieved successful operation without intraoperative accidents.The postoeprative complications were found in 19 patients,which did not lead serious consequence.The VAS and NDI scores significantly decreased,whereas the JOA score significanly increased at 2 years after operation in all the 3 groups compared with those before operation(P<0.05).The mod⁃erate-distraction group got significantly higher JOA score than the in-situ group and the over-distraction group(P<0.05),nevertheless no significant differences in the VAS and NDI scores were noted among the 3 groups at 2 years postoperatively(P>0.05).In term of radio⁃graphic assessment,the over-distraction group had significantly proximal and distal adjacent intervertebral hight loss than the in-situ group and moderate-distraction group at 2 years after operation(P<0.05).However,the cervical kyphotic angle proved significantly greater in the moderate-distraction group and the over-distraction group than the in-situ group at 2 years postoperatively(P<0.05).[Conclusion]Intervertebral distraction height does impact the clinical outcomes of ACDF,and distraction in 110%~130%is recommened in this study.
作者
陆廷盛
罗春山
欧阳北平
陈啟鸰
邓忠良
LU Tingsheng;LUO Chun-shan;OUYANG Bei-ping;CHEN Qi-ling;DENG Zhong-liang(Department of Spinal Surgery,Guizhou Orthopae-dic Hospital,Guiyang 550002,China;Department of Spinal Surgery,The Second Affiliated Hospital,Chongqing Medical University,Chongqing400010,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第3期207-210,共4页
Orthopedic Journal of China
关键词
颈椎间隙
撑开高度
邻近节段
临床疗效
cervical intervertebral space
distraction height
adjacent segments
clinical outcome
