| 摘要: |
| ［摘要］ 目的 观察颈椎前路Hybrid手术治疗双或多节段颈椎病的中短期临床疗效。方法 回顾性分析该院自2017年1月至2021年12月收治的采用Hybrid手术方式治疗的13例颈椎病患者的临床资料。采用疼痛视觉模拟量表（VAS）评分、日本整形外科协会（JOA）评分评价临床疗效；采用颈椎X线片及CT扫描三维重建等资料评估置换手术节段活动度、颈椎整体活动度、颈椎间盘假体位置、内固定融合率、异位骨化等影像学指标。结果 13例患者均获随访，随访时间8～45个月，平均14.6个月。术后置换节段活动度（9.12±1.86）°与术前（9.21±1.76）°比较差异无统计学意义(P>0.05)，颈椎整体活动度（39.67±5.57）°较术前（52.12±6.43）°显著减小（P<0.05）。术后1个月随访，VAS评分［（1.37±0.78）分］较术前［（4.85±1.25）分］显著改善（P<0.05）。术后3个月随访，JOA评分［（15.32±1.92）分］较术前［（11.36±2.11）分］显著改善（P<0.05）。术后6个月，所有患者固定节段全部融合，随访期间未见内置物松动和下沉，人工椎间盘位置良好，无异位骨化发生。术后发生近端邻椎病1例。结论 颈椎前路Hybrid手术治疗双或多节段颈椎病能明显改善患者临床症状，减少融合节段，保留颈椎活动度。该术式具有较好的临床疗效和一定的技术优势。 |
| 关键词: 颈椎前路手术 颈椎人工间盘置换术 Hybrid手术 颈椎病 |
| DOI：10.3969/j.issn.1674-3806.2023.03.02 |
| 分类号:R 681.5 |
| 基金项目:国家自然科学基金面上项目（编号：81871767）；深圳市科技计划项目（编号：JCYJ20210324115814040，SGDX20201103095600002，JCYJ20200109150641992，JCYJ20220818103417037，ZDSYS201707311542415）；深圳市发改委项目（编号：XMHT20220106001） |
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| Observation on the clinical efficacy of anterior cervical hybrid surgery in treatment of two- or multi-level cervical spondylosis |
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WU Jia-chang, FANG Guo-fang, LAI Guo-hua, et al.
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Orthopedic Center, Shenzhen Hospital of Southern Medical University, Shenzhen 518000, China; Shenzhen Clinical Medical School, Southern Medical University, Shenzhen 518000, China
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| Abstract: |
| ［Abstract］ Objective To observe the short and medium-term clinical efficacy of anterior cervical hybrid surgery in treatment of two- or multi-level cervical spondylosis. Methods The clinical data of 13 patients with cervical spondylosis who were treated with the hybrid surgery in our hospital from January 2017 to December 2021 were retrospectively analyzed. The Visual Analogue Scale(VAS) score and Japanese Orthopaedic Association(JOA) score were used to evaluate the clinical efficacy. The cervical X-ray and three-dimensional reconstruction of computed tomography(CT) scan were used to evaluate the imaging indexes such as the segmental range of motion(ROM) of replacement, the global ROM of cervical spine, the position of cervical disc prosthesis, the fusion rate of internal fixation, and heterotopic ossification. Results All the 13 patients were followed up for 8 to 45 months, with an average of 14.6 months. There was no statisticall significant difference between postoperative replacement gap mobility (9.12±1.86)° and preoperative replacement gap mobility (9.21±1.76)°(P>0.05), while for overall cervical mobility, there was a significant decrease in postoperative mobility (39.67±5.57)° compared with preoperative mobility (52.12±6.43)°(P<0.05). The mean VAS scores were (1.37±0.78)points one month after operation, which were significantly improved compared with those before operation［(4.85±1.25)points］(P<0.05). The mean JOA scores were (15.32±1.92)points three months after operation, which were significantly improved compared with those before operation［(11.36±2.11)points］(P<0.05). The fixed segments of all the patients were fused 6 months after operation, and the position of the artificial disc was good, with no implant loosening, subsidence, and no heterotopic ossification occurred. Proximal adjacent segment degeneration occurred in 1 case after operation. Conclusion The hybrid procedure of anterior cervical artificial disc replacement combined with fusion internal fixation for two- or multi-level cervical spondylosis can significantly relieve the patients′ clinical symptoms, reduce the number of fused segments and preserve cervical mobility.This operation procedure has good clinical efficacy and certain technical advantages. |
| Key words: Anterior cervical surgery Cervical artificial disc replacement Hybrid surgery Cervical spondylosis |
