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不同后路减压手术治疗胸上段脊柱狭窄合并多节段颈椎狭窄的临床疗效。

Clinical effectiveness of treatment of combined upper thoracic spinal stenosis and multilevel cervical spinal stenosis with different posterior decompression surgeries.

机构信息

Department of Orthopedic Surgery, China-Japan Union Hospital, Jilin University, Jilin, 130033, China.

Department of Gynaecology and Obstetrics, China-Japan Union Hospital, Jilin University, Jilin, 130033, China.

出版信息

Int J Surg. 2018 Jul;55:220-223. doi: 10.1016/j.ijsu.2018.02.060. Epub 2018 Mar 10.

DOI:10.1016/j.ijsu.2018.02.060
PMID:29535014
Abstract

OBJECTIVE

To explore the clinical effectiveness of various posterior decompression surgeries in the treatment of upper thoracic spinal stenosis combined with multilevel cervical spinal stenosis.

METHODS

From January 2010 to December 2015, 22 consecutive patients with combined upper thoracic spinal stenosis and multilevel cervical spinal stenosis were treated with two different approaches of posterior decompression surgeries. In group A with 10 patients, both cervical and thoracic spinal decompression surgeries were performed simultaneously (one-stage surgery); in group B with 8 patients, cervical and thoracic spinal decompression surgeries were performed separately within three months (two-stage surgery). Based on Japanese Orthopedic Association (JOA) scores, improvement rate and extent of neurological function were calculated and the difference was compared between the two groups.

RESULTS

There was no significant difference in demographic data between the two groups. However, compared with those of group B, both short-term and long-term improvement rate of neurological function in group A was higher (P < 0.05). In addition, the hospitalization cost was also lower in group A.

CONCLUSION

Both one-stage and two-stage posterior decompression surgeries were effective in treating patient with upper thoracic spinal stenosis combined with multilevel cervical spinal stenosis; however, one-stage combined surgery was superior to two-stage surgery.

摘要

目的

探讨不同后路减压手术治疗胸上段脊柱狭窄合并多节段颈段脊柱狭窄的临床疗效。

方法

自 2010 年 1 月至 2015 年 12 月,连续 22 例胸上段脊柱狭窄合并多节段颈段脊柱狭窄患者采用两种不同的后路减压手术方法进行治疗。A 组 10 例患者同时进行颈椎和胸椎减压手术(一期手术);B 组 8 例患者在 3 个月内分别进行颈椎和胸椎减压手术(二期手术)。根据日本矫形协会(JOA)评分计算神经功能的改善率和改善程度,并比较两组之间的差异。

结果

两组患者的人口统计学数据无显著差异。然而,与 B 组相比,A 组患者的短期和长期神经功能改善率均更高(P<0.05)。此外,A 组的住院费用也较低。

结论

一期和二期后路减压手术均能有效治疗胸上段脊柱狭窄合并多节段颈段脊柱狭窄患者;然而,一期联合手术优于二期手术。

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Clinical effectiveness of treatment of combined upper thoracic spinal stenosis and multilevel cervical spinal stenosis with different posterior decompression surgeries.不同后路减压手术治疗胸上段脊柱狭窄合并多节段颈椎狭窄的临床疗效。
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