颈椎前路减压融合与人工颈椎椎间盘置换联合对多节段颈椎病的疗效及邻近节段退变的影响分析

摘要

Objective:To research the impact analysis of effect and adjacent segment degeneration of anterior cervical decompression and fusion (ACDF) combined with cervical artificial disc replacement (ACDR) in the treatment of multilevel cervical spondylosis.Methods:57 cases of cervical spondylosis patients in our hospital were selected as the research objects,according to the admission,the patients were divided into the observation group (32 cases) and the control group (25 cases).The patients in the control group were treated with ACDF,while the patients in observation group were treated with Hybrid operation of cervical spine(ACDF combined with ACDR).The clinical therapeutic effect and adjacent segment degeneration in two groups compared.Results:The amount of bleeding,operation time and hospital stay in the observation group were significantly lower than those in the control group (P<0.05).In the two groups of patients with lumbar function improvement,the total effective rate of the observation group was 90.63%,and there was no significant difference compared with the control group (92.00%) (P<0.05).Before operation,3 months,6 months and 12 months after operation,There was no significant difference in JOA score and NDI score between the two groups (P>0.05).12 months after operation,the overall activity of the cervical spine in the observation group was significantly higher than the control group,and the upper and lower adjacent segments were significantly lower than those in the control group (P<0.05).Conclusion:In the treatment of multilevel cervical spondylosis,ACDF combined with ACDR can get better therapeutic effect.It can reduce the load of adjacent segment motion and reduce the occurrence of adjacent segment degeneration.In addition, it has small trauma, quick recovery prognosis and less complications.%目的:探究颈椎前路减压融合术(anterior cervical decompression and fusion,ACDF)联合人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)在治疗多节段颈椎病上的临床疗效及对其邻近节段退变的影响.方法:按入院先后将本院收治的57例多节段颈椎病患者分为观察组(32例)和对照组(25例).对照组患者给予ACDF进行治疗;观察组患者则采用颈椎Hybrid手术方式(ACDF联合ACDR)进行治疗.就两组患者的临床治疗效果以及邻近节段退变情况进行对比性分析.结果:观察组患者的术中出血量、手术时间以及住院时间均明显低于对照组(P<0.05).在两组患者的腰椎功能改善上,观察组的总有效率为90.63%,与对照组(92.00%)比较并未见明显差异(P<0.05).在术前、术后3个月、术后6个月和术后12个月,两组患者在JOA评分以及NDI评分均未见显著差异(P>0.05).术后12个月,观察组患者的颈椎整体活动度明显大于对照组,其上、下位邻近节段活动度则明显低于对照组(P<0.05).结论:在治疗多节段颈椎病上,ACDF联合ACDR疗效显著,能够减少邻近节段运动的负荷,降低了邻近节段退变的发生,此外还具有创伤小、恢复快、并发症少的特点.