[1]王国壮 张雷鸣 张剑宁 康建刚 穆俊康 任 斌 白茫茫.脊柱内镜下半椎板切除术与ACDF治疗颈椎管狭窄症的对比分析[J].中国临床神经外科杂志,2021,26(05):343-345.[doi:10.13798/j.issn.1009-153X.2021.05.008]
 WANG Guo-zhuang,ZHANG Li-ming,ZHANG Jian-ning,et al.Comparison of outcomes between spinal endoscopic hemi-laminectomy and ACDF for patients with cervical spinal stenosis[J].,2021,26(05):343-345.[doi:10.13798/j.issn.1009-153X.2021.05.008]
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脊柱内镜下半椎板切除术与ACDF治疗颈椎管狭窄症的对比分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年05期
页码:
343-345
栏目:
论著
出版日期:
2021-05-25

文章信息/Info

Title:
Comparison of outcomes between spinal endoscopic hemi-laminectomy and ACDF for patients with cervical spinal stenosis
文章编号:
1009-153X(2021)05-0343-03
作者:
王国壮 张雷鸣 张剑宁 康建刚 穆俊康 任 斌 白茫茫
716000 陕西延安,延安大学附属医院神经外科(王国壮、康建刚、白茫茫);100048 北京,中国人民解放军总医院第一医学中心神经外科医学部(张雷鸣、张剑宁、任 斌),中医医学部(穆俊康)
Author(s):
WANG Guo-zhuang1 ZHANG Li-ming2 ZHANG Jian-ning2 KANG Jian-gang1 MU Jun-kang3 REN Bin2 BAI Mang-mang1.
1.Department of Neurosurgery, Affiliated Hospital of Yan’an University, Shaanxi 716000, China; 2. Department of Neurosurgery, The First Medical Center of PLA General Hospital, Beijing 100048, China; 3. Department of Traditional Chinese Medicine, The First
关键词:
颈椎管狭窄症脊髓型颈椎病脊柱内镜半椎板切除术颈椎前路椎间盘切除融合术(ACDF)
Keywords:
Cervical spinal stenosis Cervical spondylotic myelopathy Endoscopic hemi-laminectomy Anterior cervical discectomy and fusion (ACDF)
分类号:
R 681.5+5; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2021.05.008
文献标志码:
A
摘要:
目的 对比分析脊柱内镜下半椎板切除术和颈椎前路椎间盘切除融合术(ACDF)治疗颈椎管狭窄症(CSS)的疗效。方法 回顾性分析2015年1月至2019年12月手术治疗的50例单节段或双节段CSS的临床资料。26例行ACDF(ACDF组),24例行脊柱内镜下半椎板切除术(内镜组)。50例术后随访6~62个月,其中内镜组平均随访(24.4±16.4)个月,ACDF组平均随访(25.7±18.0)个月。结果 内镜组手术时间、术中出血量与住院时间较ACDF组均明显减少(P<0.05)。两组末次随访日本骨科协会(JOA)评分、颈椎功能障碍指数量表评分及视觉模拟量表评分较术前均明显改善(P<0.05),但两组之间均无明显差异(P>0.05)。两组JOA评分改善率、临床疗效均无统计学差异(P>0.05)。结论 脊柱内镜下半椎板切除术和ACDF治疗CSS的疗效相当,但脊柱内镜下半椎板切除术具有创伤小、风险低、恢复快等优点。
Abstract:
Objective To compare the clinical effect of endoscopic hemi-lamiectomy (EHL) and anterior cervical discectomy and fusion (ACDF) on the patients with cervical spinal stenosis (CSS). Methods The clinical data of 50 patients with CSS, of whom 26 patients received ACDF (ACDF group) and 24 received EHL (EHL group) from January 2015 to December 2019, were analyzed retrospectively. The follow-up of these 50 patients ranged from 6 months to 62 months. The average follow-up time was (24.4±16.4) months in EHL group and (25.7±18.0) in ACDF group. Results The operation time, intraoperative blood loss and hospital stay in the EHL group significantly reduced compared with the ACDF group (P<0.05). The scores of Japanese Orthopaedic Association (JOA) scale, neck disabilitv index scale and visual analogue scale significantly decreased in both groups at last follow-up than those before the operation (P<0.05), but there was no statistically significant difference between the two groups at last follow-up (P>0.05). There was no statistically significant difference in the improvement rate of JOA score and clinical effectiveness between the two groups at last follow-up (P<0.05). Conclusions EHL and ACDF have the similar curative effect on the patients with CSS, but EHL has the advantages of less trauma, low risk, and quick recovery.

参考文献/References:

[1] Toledano M, Bartleson JD. Cervical spondylotic myelopathy[J]. Neurol Clin, 2013, 31(1): 287-305.
[2] Bakhsheshian J, Mehta VA, Liu JC. Current diagnosis and management of cervical spondylotic myelopathy [J]. Global Spine J, 2017, 7(6): 572-586.
[3] McGrath LB, White-Dzuro GA, Hofstetter CP. Comparison of clinical outcomes following minimally invasive or lumbar endoscopic unilateral laminotomy for bilateral decompre-ssion [J]. J Neurosurg Spine, 2019: 40(4): 417-550.
[4] Ahn Y. Current techniques of endoscopic decompression in spine surgery [J]. Ann Transl Med, 2019, 7(Suppl 5): 169-179.
[5] 杨俊松,楚 磊,王永峰,等. 经皮脊柱内镜在治疗胸椎管狭窄症中的应用研究[J]. 中国骨与关节杂志,2019,8(2):98-104.
[6] Hirabayashi K, Miyakawa J, Satomi K, et al. Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament [J]. Spine (Phila Pa 1976), 1981, 6(4): 354-364.
[7] Fehlings MG, Tetreault LA, Wilson JR, et al. Cervical spon-dylotic myelopathy: current state of the art and future direc-tions [J]. Spine (Phila Pa 1976), 2013, 38(22 Suppl 1): 1-8.
[8] Farrokhi MR, Ghaffarpasand F, Khani M, et al. An evi-dence-based stepwise surgical approach to cervical spon-dylotic myelopathy: a narrative review of the current litera-ture [J]. World Neurosurg, 2016, 94: 97-110.
[9] 李 勤,田 伟. 应根据特点选择退行性颈椎管狭窄症的前后路手术方法[J]. 中华医学杂志, 2011,91(31):2161-2162.
[10] Carr DA, Abecassis IJ, Hofstetter CP. Full endoscopic uni-lateral laminotomy for bilateral decompression of the cervi-cal spine: surgical technique and early experience [J]. JSpine Surg, 2020, 6(2): 447-456.
[11] 肖福涛,邓忠良. 经皮内镜下颈椎板黄韧带切除术治疗颈椎管狭窄症的可行性研究[D]. 重庆医科大学,2015.
[12] 袁 恒,张西峰. 脊柱内镜手术与颈前路减压融合术治疗脊髓型颈椎病疗效的对比研究[D]. 山西医科大学,2019.

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备注/Memo

备注/Memo:
通讯作者:白茫茫,E-mail:yabaimm@163.com
更新日期/Last Update: 2021-05-25