显微镜辅助下前路颈椎间盘切除减压椎间植骨融合术治疗单节段脊髓型颈椎病

目的:比较显微镜辅助下前路颈椎间盘切除减压椎间植骨融合术(anterior cervical discectomy and fusion,ACDF)与常规ACDF术治疗单节段脊髓型颈椎病的临床疗效.方法: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,男55例,女34例,年龄(52.00±1...

Microscope assisted anterior cervical discectomy and fusion for the treatment of single-segment cervical spondylotic myelopathy

Objective: 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. Methods: 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_3,4 in 3 cases,C_4,5 in 10 cases,C_5,6 in 15 cases,C_6,7 in 6 cases; 55 cases were treated with microscope-assisted anterior cervical discectomy with fusion (microscope group),including C_3,4 in 5 cases,C_4,5 in 23 cases,C_5,6 in 20 cases,C_6,7 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). Results: Intraoperative blood loss and hospital stay in microscope group were less than those in conventional group (P<0.05),and operative time of conventional group was shorter than that of microscope group (P<0.05). Postoperative JOA,VAS and ODI were significantly improved in each groups (P<0.05). VAS scores of microscope group were better than that of conventional group at 1 week and 3 months after operation(P<0.05),but there was no statistically significant difference between two groups at 12 months after operation(P>0.05). JOA scores of microscope group at each postoperative follow-up were better than that of conventional group(P<0.05). ODI scores of microscope group at 3,12 months after operation were better than that of conventional group (P<0.05). Conclusion: 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.