【摘要】 目的探讨改良后路手术与一期后前路联合手术治疗脊髓型合并神经根型颈椎病的疗效及安全性。方法选取2015年2月至2018年2月本院收治的78例脊髓型合并神经根型颈椎病患者作为研究对象,采用随机数表法将其分为对照组和研究组,每组各39例。研究组患者行颈后路保留一侧肌肉韧带复合体联合椎间孔切开治疗,对照组患者行一期后前路联合手术治疗,比较两组患者手术情况、视觉模拟评分法(visual analogue scale,VAS)评分、日本骨科协会(Japanese Orthopaedic Association,JOA)评分、颈椎功能残障指数表(neck disability index,NDI),同时记录两组术后并发症发生情况。结果研究组患者手术时间明显短于对照组(P <0.05),术中出血量明显少于对照组(P <0.05);两组患者术后VAS、JOA及NDI评分均明显优于本组术前(P_均<0.05),研究组患者术后VAS、JOA及NDI评分、JOA改善率均明显优于对照组(P_均<0.05);研究组患者术后并发症发生率明显低于对照组(χ~2=7.690,P=0.006)。结论颈后路保留一侧肌肉韧带复合体联合椎间孔切开治疗脊髓型合并神经根型颈椎病的临床疗效更为显著,可有效减轻颈部疼痛,改善脊髓功能,促进颈椎功能恢复,降低术后并发症发生率,安全性高。更多还原

【Abstract】 Objective To investigate the clinical ef?cacy and safety of modi?ed posterior approach and one-stage posterior-anterior approach in surgical treatment for cervical myelopathy associated with radiculopathy. Method 78 cases of cervical myelopathy associated with radiculopathy treated in our hospital from Feb 2015 to Feb 2018 were selected and divided into two groups according to the random number table, each with 39 cases. The study group received foraminotomy with preservation of unilateral muscle ligament complex, while the control group received one-stage posterior-anterior approach. The operative status, visual analogue scale（VAS） score, Japanese Orthopaedic Association（JOA） score, and neck disability index（NDI） and postoperative complications were compared between the two groups. Result The operative time and intraoperative blood loss in study group were signi?cantly shorter than that of control group（P < 0.05）. Postoperative VAS, JOA and NDI scores were signi?cantly better than those before surgery in both groups(P_all< 0.05), which were more signi?cant in study group than that in control group(P_all< 0.05). The incidence of postoperative complications in study group was signi?cantly lower than that of control group（χ²= 7.690, P = 0.006）. Conclusion The application of foraminotomy with preservation of unilateral muscle ligament complex is an effective and safety way to reduce the degree of neck pain, improve the spinal cord function, promote the recovery of cervical spine function, and reduce the incidence of postoperative complications for cervical myelopathy patients associated with radiculopathy.更多还原