LF与ACDF在混合型颈椎病患者中的临床疗效及安全性的对比分析

目的:对比分析后路椎板成形联合椎间孔切开术式(laminoplasty with for aminotomy,LF)与颈前路椎间盘切除减压融合术(anterior cervical discectomy and fusion,ACDF)在混合型颈椎病患者中的临床疗效及安全性。方法:分析148例混合型颈椎病患者的临床资料。根据手术治疗方式的不同,将入选者分成观察组(LF治疗,43例)和对照组(ACDF治疗,105例)两组。比较两组患者的临床疗效、随访结束时颈椎神经功能障碍指数量表(NDI)评分及并发症发生率。结果:观察组患者的手术时间及颈椎曲度明显低于对照组,但术中出血量及下肢感觉改善率明显高于对照组(P<0.05);随访结束时观察组患者提物及开车项目的评分明显高于对照组(P<0.05);观察组总并发症发生率(11.6%)明显低于对照组(28.6%)(χ2=4.850,P=0.03)。结论:混合型颈椎病患者采用LF术式治疗的临床疗效突出,可有效解除脊髓受压症状,且安全性良好。

Comparative analysis of the clinical efficacy and safety of LF and ACDF in the patients with mixed cervical spondylosis

Objective:To compare and analyze the clinical efficacy and safety of laminoplasty with for aminotomy(LF) and an-terior cervical discectomy and fusion (ACDF) in patients with mixed cervical spondylosis.Methods:Clinical data of 148 patients with mixed cervical spondylosis were retrospectively analyzed.All patients were divided into the observation group (LF,43 cases) and the control group (ACDF,105 cases).The clinical efficacy,the NDI scores at the end of follow-up and the complication rates in two groups were compared.Results:The operation time and cervical curvature in the observation group were obviously lower than those in control group,but the amount of intraoperative bleeding,improvement rate of lower limb sensory in the observation group were obviously higher than those in control group(P<0.05).At the end of follow-up,the lift and drive score in observation group were obviously higher than those in control group (P<0.05).The complication rate(11.6%) in the observation group was obviously lower than that in the con-trol group (28.6%) (χ2=4.850,P=0.03).Conclusion:The clinical efficacy of LF in treating the patients with mixed cervical spon-dylosis is obvious,which can relieve the symptoms of compression of the spinal cord.Its safety is better.