摘要
目的 比较前路融合手术(ACDF/ACCF)与后路单开门手术治疗多节段颈椎退变的效果。方法 选取2008~2018年成都市第二人民医院收治的200例多节段退变性颈椎手术患者(≥3个椎体),根据治疗方法不同分为前路组和后路组,每组各100例。前路组行ACDF/ACCF手术,后路组行颈椎后路单开门扩大成形手术,对上述两组患者进行比较分析,比较两组患者术后伤口情况、有无肺栓塞、有无DVT形成、神经并发症发生情况、吞咽困难占比、住院时长及手术翻修率情况、住院费用及保守治疗的费用等。结果 术后前路组的伤口感染占比、伤口裂口占比、伤口血肿占比、DVT占比、神经并发症占比、吞咽困难占比、住院时长占比、住院费用占比等指标均低于后路组,差异均有统计学意义(P<0.05)。术后前路组吞咽困难发生率6%,后路单开门手术组为1%,后路组吞咽困难发生率明显小于前路组。前路手术1个月内并发症发生的概率较低,其中伤口感染率为1%,后路手术伤口感染率为5%,前路组明显低于后路组。前路组的住院费用比较低,约(15 632±78)元,后路组住院费用较高,约(26 324±48)元。前路手术组住院时间较短约(8.7±1.2)d,后路手术组约(13.6±1.3)d。结论 就治疗多节段颈椎退变来说,前路ACDF/ACCF手术较后路单开门手术的优点更多,有较低的并发症发生率,住院时间更短,住院费用更低。
Objective To compare the effect of anterior fusion surgery and posterior single open-door surgery in the treatment of multi-level cervical degeneration. Methods A total of 200 patients with multi-level cervical degeneration undergoing surgery in Chengdu Second People′s Hospital from 2008 to 2018(≥ 3 affected segments) were colleoted and divided into the anterior approach group and the posterior approach group according to treatment methods,with 100cases in each group.The anterior group underwent anterior cervical discectomy and fusion/anterior cervical corpectomy and fusion(ACDF/ACCF),and the posterior group underwent cervical posterior single open-door expansive laminoplasty.The above two groups were compared and analyzed, and the following indicators were compared between the two groups of patients:Postoperative wound conditions, occurrence of pulmonary embolism,deep venous thrombosis(DVT) formation and neurological complications,the proportion of dysphagia,length of hospital stay, surgical revision rate,the cost of hospitalization and conservative treatment, etc. Results The anterior approaoh group of postoperative wound infection,wound dehiscence, wound hematoma, DVT,neurological complications, dysphagia, length of hospital stay and hospitalization costs and other indicators in the anterior approach group were lower than those in the posterior approach group,with statistically significant differences(P<0.05).The incidence of anterior approaoh group after anterior surgery was 6%,while the postelior appvoaoh group was 1%, and the incidence of anterior approaoh group was significantly lower than the postelior appvoaoh group. The anterior approaoh group of complications occurring within one month after the anterior surgery was low, including wound infection rate of 1%. The wound infection rate for the postelior appvoaoh group was significantly lower than that for posterior surgery(5%).The hospitalization cost of anterior approaoh group was low,about(15 632±78)yuan,and the hospitalization cost of the postelio
作者
冉波
曾勇
RAN Bo;ZENG Yong(Department of Orthopedics,Chengdu Second People′s Hospital,Chengdu 617000,China)
出处
《中国现代医生》
2022年第10期77-80,共4页
China Modern Doctor
关键词
多节段
颈椎病
前路
单开门
并发症
Multi-level
Cervical spondylopathy
Anterior approach
Single open-door
Complication
