• 医学文献
  • 知识库
  • 评价分析
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
论文 期刊
高级检索

检索历史 清除

双节段Hybrid手术治疗颈椎病的临床疗效观察

Clinical outcomes of Hybrid-Surgery to treat the two-level cervical disease

摘要:

目的 评估颈椎人工间盘置换结合颈椎椎间融合(Hybrid手术)治疗颈椎病的临床疗效及其对相邻颈椎节段的影响.方法 回顾性分析2007年12月至2010年6月共17例因颈椎病行双节段Hybrid手术患者(Hybrid组)的临床资料,选取同期行颈椎前路减压融合手术(ACDF)的17例患者作为对照(ACDF组).对两组患者术前、术后1、3、6个月的日本骨科协会评分(JOA)、颈椎功能障碍指数评分( NDI)、C2~7整体活动度、手术相邻颈椎节段活动度等结果进行对照评价.结果 Hybrid组和ACDF组患者术后JOA评分、NDI评分较术前均有改善(JOA:t=-8.790~-5.803,P<0.05;NDI:t 10.717 ~ 13.514,P<0.05),但两组之间差异无统计学意义(P>0.05).两组患者术后颈椎活动度较术前均明显降低,Hybrid组由术前46°±11°降至术后6个月的41°±8°(t=3.170,P<0.05),ACDF组由术前的45°±13°降至术后6个月的38°±15°(t=6.709,P<0.05),但两组之间差异无统计学意义(P>0.05).Hybrid组患者术后1、3个月上位相邻节段和下位相邻节段的颈椎活动度较术前均降低,差异有统计学意义(上位:t=5.622和4.032,P<0.05;下位:t=2.879和2.207,P<0.05),术后6个月时差异无统计学意义(P>0.05).ACDF组术后颈椎相邻节段活动度术后3、6个月时下位相邻节段颈椎活动度较术前升高,差异有统计学意义(t=-7.038和- 13.540,P<0.05),术后6个月时上位相邻节段颈椎活动度较术前升高,差异有统计学意义(t=-2.453,P<0.05).结论 双节段Hybrid手术对于治疗颈椎病拥有满意的临床疗效和影像学结果,Hybrid手术患者在随访期间相邻节段颈椎活动度降低,而ACDF手术患者在随访期间相邻节段颈椎活动度增加.Hybrid手术的远期临床效果,还需要进一步随访验证.

更多
abstracts:

Objective To evaluate the clinical and radiologic outcomes of the Hybrid surgery (cervical artificial disc replacement combined with anterior cervical discectomy and fusion(ACDF) ) and the effective of the adjacent segment.Methods Between December 2007 to June 2010,34 patients underwent 2-level cervical disc surgery.There were 17 patients underwent Hybrid surgery( Hybrid group),17 patients underwent 2-level ACDF (ACDF group).Japanese orthopaedic association (JOA),neck disability index (NDI),and Odom's standards were evaluated. Dynamic flexion and extension lateral cervical radiographs were obtained in the standing position before surgery and at routine postoperative intervals of 1,3,6 months.Results Both of the two groups had significantly improvement than preoperative in JOA ( t =- 8.790--5.803,P < 0.05 ) and NDI scores ( t =10.717-13.514,P < 0.05 ),but no significantly difference between the two groups ( P > 0.05 ).Both of the two groups had significantly decreased in the mean C2-7 range of motion(ROM).The Hybrid group decreased from 46° ± 11° preoperative to 41° ± 8° at the 6 mouths after surgery (t =3.170,P < 0.05 ).The ACDF group decreased from 45° ± 13°preoperative to 38° ± 15°at the 6 mouths after surgery ( t =6.709,P < 0.05 ).But there were no significantly difference between the two groups(P > 0.05).In the Hybrid group,both the superior adjacent segment ROM and the inferior adjacent segment ROM were decreased in the follow-up,there had significantly difference at the 1 and 3 months after surgery ( superior adjacent segment:t =5.622 and 4.032,P < 0.05 ; inferior adjacent segment:t =2.879 and 2.207,P < 0.05),but no significantly difference after 6 months ( P > 0.05).In the ACDF group,the ROM of the inferior adjacent segment was significantly increased at 3 and 6 months after surgery ( t =- 7.038 and - 13.540,P < 0.05 ),the ROM of the superior adjacent segment was significantly increased at 6 months after surgery ( t =- 2.453,P < 0.05 ).Conclusions Hybrid surgery has excellent clinical results and decreases the ROM of the adjacent segment in the following 6 months,meanwhile 2-level ACDF increases the ROM of the adjacent segment.The long-term clinical outcomes of the Hybrid surgery need more study.

More
  • 浏览:167
  • 下载:31

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

充值 订阅 收藏 移动端 使用
帮助