【摘 要】
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目的 比较经椎间隙减压融合术(ACDF)与椎体次全切减压融合术(ACCF)治疗相邻两节段脊髓型颈椎病患者的临床疗效及邻近节段退变发生率的差异.方法 回顾分析60例相邻两节段颈椎
【机 构】
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313000,浙江省湖州市中心医院
论文部分内容阅读
目的 比较经椎间隙减压融合术(ACDF)与椎体次全切减压融合术(ACCF)治疗相邻两节段脊髓型颈椎病患者的临床疗效及邻近节段退变发生率的差异.方法 回顾分析60例相邻两节段颈椎病患者,据手术方式分为2组,A组33例行ACDF术;B组27例行ACCF术,比较两组手术时间、术中出血量、JOA评分、颈椎曲度变化、融合节段椎间高度、植骨融合率、内固定失败率及邻近节段退变发生率的差异情况.结果 所有患者均获得随访,时间36～72个月.A组手术时间长于B组,出血量少于B组,差异有统计学意义.两组术后JOA评分、融合节段高度及颈椎曲度与术前比较差异均有统计学意义;组间颈椎曲度及融合节段高度差异有统计学意义,但组间JOA评分比较差异无统计学意义.B组出现内植入物并发症,A组未出现.末次随访均达到骨性融合标准.按Hilibrand影像学标准,A组邻近节段发病率低于B组,差异有统计学意义.结论 两种方法治疗双节段颈椎病均可获得满意的临床疗效.与ACDF比较,ACCF手术时间短,但手术创伤大、出血量多,在改善融合节段高度及颈椎曲度方面较差,有内固定失败现象,有较高的邻近节段退变发生率.
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