摘要
目的探讨改良全椎板切除结合融合术治疗多节段脊髓型颈椎病的临床疗效。方法选取2016年4月至2021年1月肇庆市第一人民医院收治的89例多节段脊髓型颈椎病患者作为研究对象,根据手术方式不同分为对照组(n=43)与观察组(n=46)。对照组采用传统C_(3~7)单开门椎管扩大成形术,观察组采用潜行咬除C_(3~7)及C_(3~7)部分椎板保留棘突结合C_(4~6)全椎板切除及侧块螺钉固定融合。比较两组手术相关指标(手术时间、术中出血量),术后并发症发生情况,术前及术后3、6个月的颈椎Cobb角。结果观察组手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义;术后3、6个月,两组Cobb角均低于前一时间点,且观察组低于对照组,差异有统计学意义(P<0.05)。结论与传统单开门椎管扩大成形术比较,改良全椎板切除结合融合术治疗多节段脊髓型颈椎病手术时间短,可减少术中出血量,改善患者术后颈椎轴向疼痛,降低Cobb角下降幅度。
Objective To investigate the clinical efficacy of modified total laminectomy combined with fusion in the treatment of multi-segmen-tal cervical spondylotic myelopathy.Methods 89 patients with multi-segmental cervical spondylotic myelopathy admitted to Zhaoqing First People's Hospital from April 2016 to January 2021 were selected as the research subjects.,they were divided into the control group(n=43)and the observation group(n=46)according to different surgical methods.The control group adopted traditional C_(3-7) single open canal plasty,and the observation group adopted C_(3-7) and C_(3-7) lamina combined with C_(4-6) total laminectomy and lateral block screw fixation and fusion.Comp-related indicators(operation time,intraoperative blood volume),postoperative complications,and cervical Cobb angle before and 3 and 6 months after surgery.Results The op-eration time in the observation group was shorter than that in the control group,and the amount of blood loss during operation was less than that of control group,the difference was statistically significant(P<0.05).There was no significant difference in complication rate between the two groups.At 3 and 6 months after operation,the Cobb Angle of both groups was lower than the previous time point,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion The modified total laminectomy and fusion for the treatment of multilevel cervical spondylosis is shorter compared with the traditional single-door vertebroplasty,the amount of intraoperative bleeding is reduced,and the incidence of postoperative cervical axial pain is reduced,and the decrease of Cobb angle is low.
作者
罗瑞文
LUO Ruiwen(Department of Orthopedics,the First People's Hospital of Zhaoqing,Zhaoqing,Guangdong,526000,China)
出处
《当代医学》
2023年第30期172-175,共4页
Contemporary Medicine
