单节段和双/多节段颈椎前路减压融合术后椎前软组织肿胀及吞咽困难发生率的比较

目的比较分析单节段和双/多节段颈椎前路融合术后椎前软组织肿胀程度和吞咽困难发生率。方法纳入颈椎前路融合术病例123例,单节段组50例,双/多节段组73例,在侧位X线片上测量椎前软组织宽度,比较术后椎前软组织肿胀程度及吞咽困难发生率。结果单节段组术后椎前软组织肿胀宽度为(8.29±3.98)mm,吞咽困难发生率为40.0%,均低于双/多节段组的(11.14±5.17)mm和64.4%。且无论高位(C4/C5节段及以上)或低位手术(C5节段以下),单节段术后椎前软组织肿胀宽度和吞咽困难发生率均低于双/多节段术后。结论多节段手术可能是颈椎前路手术术后椎前软组织肿胀和吞咽困难发生的危险因素之一,术前针对相关人群的宣教具有一定的必要性和临床意义。

Comparison of prevertebral soft tissue swelling and dysphagia rate between single-level and double/multiple-level anterior cervical decompression and fusion

Objective To investigate the prevertebral soft tissue swelling and dysphagia rate after single-level or double/multiple-level anterior cervical decompression and fusion.Methods A total of 123 patients undering anterior cervical fusion with plate augmentation for cervical spondylosis were included in the study. The patients were divided into single-level group (n=50) and double/multiple-level group (n=73). The postoperative prevertebral soft tissue swelling was measured with lateral roentgenograph. The postoperative prevertebral soft tissue swelling and dysphagia rate were analysed. Meanwhile, to eliminate the impact of operative site on the results, patients were further divided into high-level group (above C₅, including C₄/C₅) and low-level group (below C₅). Then the data was compared between single-level group and double/multiple-level group. Results Postoperative prevertebral soft tissue swelling and dysphagia rate in single-level group were (8.29 ± 3.98) mm and 40.0%, which were less than that in double/multiple-level group (11.14 ± 5.17) mm and 64.4%. For both high-level operation and low-level operation, postoperative prevertebral soft tissue swelling and dysphagia rate in single-level group were less than those in double/multiple-level group.Conclusion Multiple-level surgery is possibly one of the risk factors of prevertebral soft tissue swelling and dysphagia after anterior cervical surgery. Announcement to relevant patients before the operation might be necessary and clinically meaningful procedure.