摘要
目的:观察颈椎前路V形截骨Y形减压融合术(anterior cervical V-osteotomy Y-decompression and fusion,ACVYF)治疗颈椎后纵韧带骨化症的临床疗效。方法:回顾性分析2018年6月~2022年10月在河南省洛阳正骨医院行手术治疗的60例单节段椎体层面后纵韧带骨化症患者的临床资料,其中30例采用ACVYF治疗(ACVYF组),男18例,女12例;年龄47~65岁(61.0±6.4岁),体质指数16.8~28.1kg/m^(2)(23.67±2.86kg/m^(2));病程10~80个月(37.5±20.1个月);手术节段:C32例、C45例、C513例、C610例。30例采用颈前路椎体次全切除减压融合术(anterior cervical corpectomy decompression and fusion,ACCF)治疗(ACCF组),男19例,女11例;年龄44~68岁(59.5±6.8岁);体质指数16.6~26.4kg/m^(2)(23.30±2.56kg/m^(2));病程13~72个月(35.8±18.8个月);手术节段:C33例、C46例、C512例、C69例。两组性别、年龄、体质指数、病程、手术节段等一般资料比较无统计学差异(P>0.05),具有可比性。比较两组手术时间、术中出血量、并发症;术前和术后1周、3个月、6个月、12个月进行颈椎日本骨科协会(Japanese Orthopaedic Association,JOA)评分,计算术后12个月时的JOA评分改善率;术前和术后1周、3个月、6个月和12个月在X线片上测量融合区高度、C2~7 Cobb角;术后3个月、6个月和12个月时在X线片或CT片上观察植骨融合情况。结果:两组患者均顺利完成手术,ACVYF组手术时间为88.2±19.7min,术中出血量为133.3±24.4mL;ACCF组手术时间为91.5+24.1min,术中出血量为137.7±29.4mL,两组手术时间和术中出血量比较均无统计学差异(P>0.05)。ACVYF组与ACCF组术后各有3例患者发生吞咽困难,1~2周后均自行缓解,随访期间无其他并发症发生,两组并发症发生率无统计学差异(P>0.05)。两组术后各时间点颈椎JOA评分与术前比较均有显著性改善(P<0.05),两组间同时间点比较均无统计学差异(P>0.05);两组术后各时间点融合区高度和C2~7 Cobb角与术前比较均有�
Objectives:To observe the clinical efficacy of anterior cervical V-osteotomy Y-decompression and fusion(ACVYF)for treating ossification of posterior longitudinal ligament(OPLL)in cervical spine.Methods:The clinical data of 60 patients with single-segment vertebral level OPLL who underwent surgical treat ment in Luoyang Orthopedic Traumatological Hospital of He′nan Province from June 2018 to October 2022 were retrospectively analyzed.Among them,30 cases were treated with ACVYF operation(ACVYF group),including 18 men and 12 women,aged 47-65 years(61.0±6.4 years),with a body mass index(BMI)of 16.8-28.1kg/m^(2)(23.67±2.86kg/m^(2))and a disease duration of 10-80 months(37.5±20.1 months),whose surgical segments fell in C3 in 2 cases,C4 in 5 cases,C5 in 13 cases,C6 in 10 cases.The other 30 cases were treated with anterior cervical corpectomy decompression and fusion(ACCF)operation(ACCF group),including 19 men and 11 women,aged 44-68 years(59.5±6.8 years),with a BMI of 16.6-26.4kg/m^(2)(23.30±2.56kg/m^(2))and a disease duration of 13-72 months(35.8±18.8 months),whose surgical segments fell in C3 in 3 cases,C4 in 6 cases,C5 in 12 cases,C6 in 9 cases.The two groups were comparable in gender,age,BMI,disease duration,surgical section and other general information with no statistical difference(P>0.05).The operation time,intraoperative bleeding,and complications of the two groups were compared;The cervical Japanese Orthopaedic Association(JOA)scores were recorded before operation,at 1 week,and 3,6 and 12 months after operation,and the JOA score improvement rate was calculated at postoperative 12 months;The height of the fusion area and C2-7 Cobb angle were measured on X-ray films at pre-operation,1 week,3 months,6 months and 12 months after operation.The fusion condition of implants were observed and evaluated on X-ray film or CT image at 3 months,6 months and 12 months after operation.Results:The operation was completed smoothly in both groups.The operation time and intraoperative bleeding were 88.2±19.7min and 133.
作者
宋仁谦
周英杰
郑怀亮
禚汉杰
闫飞鸿
王彦金
SONG Renqian;ZHOU Yingjie;ZHENG Huailiang(Department of Spinal Surgery,Luoyang Orthopedic,Traumatological Hospital of He′nan Province(He′nan Provincial Orthopedic Hospital),Luoyang,471002,China)
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2024年第5期449-457,共9页
Chinese Journal of Spine and Spinal Cord
关键词
后纵韧带骨化症
颈椎前路V形截骨Y形减压融合术
颈椎前路椎体次全切除减压融合术
置入物沉降
临床疗效
Ossification of the posterior longitudinal ligament
Anterior cervical V-osteotomy Y-decompression and fusion
Anterior cervical corpectomy decompression and fusion
Implant subsidence
Clinical efficacy
