Sun Mingxiao, Kong Lili, Jiang Zhaofu, Li Liming, Lu Bing
Department of Orthopedics (I), Yantai Yeda Hospital, Yantai Economic and Technological Development Zone, Yantai, Shandong, China (mainland).
Department of Radiology, Yantai Yeda Hospital, Yantai Economic and Technological Development Zone, Yantai, Shandong, China (mainland).
Med Sci Monit. 2017 Jun 24;23:3088-3094. doi: 10.12659/msm.901981.
BACKGROUND We aimed to compare microscope-assisted anterior cervical surgery with traditional open-base surgery for treating cervical ossification of the posterior longitudinal ligament (OPLL). MATERIAL AND METHODS Patients were grouped into microscope-assisted anterior cervical surgery group (case group, n=30) and conventional anterior cervical surgery group (control group, n=30). Baseline characteristics, intraoperative and post-operative indexes including operation time, blood loss amount, duration of hospitalization, visual analogue scale (VAS), and complication rate were recorded. The neurological functions of patients were assessed using the Japanese Orthopaedic Association (JOA) score. Furthermore, the corresponding rate of improved JOA score (RIS) in each group was also calculated to evaluate surgery outcomes. RESULTS The average blood loss amount and hospital stay duration in the case group were lower than in the control group (p<0.05). The post-operative VAS scores of both groups were decreased significantly. Particularly the post-operative VAS score in the case group was significantly lower than that in the control group (p<0.05). While the improvement rate of JOA scores in the case group was significantly higher than that in control group after cervical spine surgery. A significantly higher RIS rate was observed in the case group (p<0.05). Furthermore, post-operative complications of patients in the case group were lower than those in the control group (p<0.05). CONCLUSIONS Compared to conventional anterior cervical surgery, surgeries operated with microscope exhibit higher efficacy and safety including less bleeding amount, shorter operation time, released pain degree, improved neurological functions, and fewer incidences of complications.
背景 我们旨在比较显微镜辅助下颈椎前路手术与传统开放式手术治疗颈椎后纵韧带骨化症(OPLL)的效果。
材料与方法 将患者分为显微镜辅助下颈椎前路手术组(病例组,n = 30)和传统颈椎前路手术组(对照组,n = 30)。记录基线特征、术中及术后指标,包括手术时间、失血量、住院时间、视觉模拟评分(VAS)和并发症发生率。采用日本骨科协会(JOA)评分评估患者的神经功能。此外,还计算了每组JOA评分改善率(RIS)以评估手术效果。
结果 病例组的平均失血量和住院时间均低于对照组(p<0.05)。两组术后VAS评分均显著降低。特别是病例组术后VAS评分显著低于对照组(p<0.05)。颈椎手术后,病例组JOA评分改善率显著高于对照组。病例组的RIS率显著更高(p<0.05)。此外,病例组患者术后并发症低于对照组(p<0.05)。
结论 与传统颈椎前路手术相比,显微镜下手术具有更高的疗效和安全性,包括出血量更少、手术时间更短、疼痛缓解程度更高、神经功能改善以及并发症发生率更低。