Xu Yu-Xia, Luo Qi-Shan, Li Yuan-Hong, Wang Yong-Fu, Luo Yi, Wang Qiang, Luo Wei-Min
Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha 410004, Hunan, China.
Zhongguo Gu Shang. 2021 Apr 25;34(4):327-32. doi: 10.12200/j.issn.1003-0034.2021.04.006.
To compare the efficacy of microscope assisted anterior cervical discectomy and fusion with conventional surgical approach in the treatment of single-segment cervical spondylotic myelopathy.
The clinical data of 89 patients with single-segment cervical spondylotic myelopathy treated from March 2015 to March 2019 were retrospectively analyzed. There were 55 males and 34 females, with an average of (52.00±11.36) years old. Among the patients, 34 cases were treated with conventional anterior cervical discectomy with fusion (conventional group), including C in 3 cases, C in 10 cases, C in 15 cases, C in 6 cases; 55 cases were treated with microscopeassisted anterior cervical discectomy with fusion (microscope group), including C in 5 cases, C in 23 cases, C in 20 cases, C in 7 cases. Operative time, intraoperative blood loss, hospital stay and complications were compared between two groups. Clinical efficacy was assessed by visual analogue scale(VAS), Japanese Orthopaedics Association (JOA) scores, Oswestry Disability Index(ODI) during follow-up period (postoperative 1 week, 3 months and 12 months).
Intraoperative blood loss and hospital stay in microscope group were less than those in conventional group (<0.05), and operative time of conventional group was shorter than that of microscope group (<0.05). Postoperative JOA, VAS and ODI were significantly improved in each groups (<0.05). VAS scores of microscope group were better than that of conventional group at 1 week and 3 months after operation(<0.05), but there was no statistically significant difference between two groups at 12 months after operation (>0.05). JOA scores of microscope group at each postoperative follow-up were better than that of conventional group (<0.05). ODI scores of microscope group at 3, 12 months after operation were better than that of conventional group (<0.05).
Both methods can achieve satisfactory effect in treating single-segment cervical spondylotic myelopathy. However, microscope-assisted anterior cervical discectomy and fusion has advantages of clear vision, less bleeding and fewer intraoperative complications.
比较显微镜辅助下颈椎前路椎间盘切除融合术与传统手术方法治疗单节段脊髓型颈椎病的疗效。
回顾性分析2015年3月至2019年3月收治的89例单节段脊髓型颈椎病患者的临床资料。其中男55例，女34例，平均年龄（52.00±11.36）岁。患者中，34例行传统颈椎前路椎间盘切除融合术（传统组），其中C3 3例，C4 10例，C5 15例，C6 6例；55例行显微镜辅助下颈椎前路椎间盘切除融合术（显微镜组），其中C3 5例，C4 23例，C5 20例，C6 7例。比较两组手术时间、术中出血量、住院时间及并发症情况。随访期间（术后1周、3个月和12个月）采用视觉模拟评分法（VAS）、日本骨科协会（JOA）评分、Oswestry功能障碍指数（ODI）评估临床疗效。
显微镜组术中出血量及住院时间少于传统组（P<0.05），传统组手术时间短于显微镜组（P<0.05）。两组术后JOA、VAS及ODI均显著改善（P<0.05）。术后1周和3个月时显微镜组VAS评分优于传统组（P<0.05），但术后12个月两组差异无统计学意义（P>0.05）。显微镜组术后各随访时间点JOA评分均优于传统组（P<0.05）。显微镜组术后3个月、12个月时ODI评分优于传统组（P<0.05）。
两种方法治疗单节段脊髓型颈椎病均能取得满意疗效。然而，显微镜辅助下颈椎前路椎间盘切除融合术具有视野清晰、出血少及术中并发症少的优点。
