颈后路椎弓根螺钉固定术和颈后路侧块螺钉内固定术治疗多节段脊髓型颈椎病的效果比较(1)
【摘要】 目的：探究頸后路椎弓根螺钉固定术与颈后路侧块螺钉内固定术治疗多节段脊髓型颈椎病的效果。方法：选取笔者所在医院2014年1月-2015年5月收治的86例多节段脊髓型颈椎病(M-CSM)患者为试验对象，按照抽样方法将入选患者分为观察组及对照组，每组43例。对照组行颈后路侧块螺钉内固定术治疗，观察组行颈后路椎弓根螺钉固定术治疗。观察两组治疗后神经功能恢复情况、颈椎曲度指数、颈椎轴性症状及并发症发生率。结果：观察组术后即刻CCI、术后曲度变化与对照组比较，差异均无统计学意义(P>0.05)。观察组末次随访CCI显著低于对照组，末次随访曲度变化显著高于对照组，差异均有统计学意义(P<0.05)。观察组AS总发生率为9.30%，显著低于对照组的25.58%，差异有统计学意义(字2=3.957，P<0.05)。两组术后均无并发症发生，随访36个月，观察组无内固定松动等现象，对照组螺钉松动2例。结论：与颈后路侧块螺钉内固定术相比，颈后路椎弓根螺钉固定术治疗多节段脊髓型颈椎病具有较好的临床效果，更有助于维持颈椎的稳定性，AS发生率显著下降。
【关键词】 颈后路椎弓根螺钉固定术; 颈后路侧块螺钉内固定术; 多节段脊髓型颈椎病; 临床效果
doi：10.14033/j.cnki.cfmr.2019.24.018 文献标识码 B 文章编号 1674-6805(2019)24-00-03
【Abstract】 Objective：To evaluate the efficacy of posterior cervical pedicle screw fixation and posterior cervical lateral mass screw fixation for multi-segmental cervical spondylotic myelopathy.Method：A total of 86 patients with multi-segmental cervical spondylotic myelopathy admitted to our hospital from January 2014 to May 2015 were enrolled.According to the sampling method，patients were divided into the observation group and the control group，43 cases in each group.The control group underwent posterior cervical lateral mass screw fixation.The observation group underwent posterior cervical pedicle screw fixation.The neurological recovery，cervical curvature index，cervical axial symptoms and complication rate were observed.Result：After surgery，the changes of CCI and curvature in the observation group were compared with those of the control group，and the differences were not statistically significant(P>0.05).The final follow-up CCI of the observation group was significantly lower than that of the control group，and the change of curvature of final follow-up was significantly higher than that of the control group，and the differences were statistically significant(P<0.05).The total incidence of AS in the observation group was 9.30%，which was significantly lower than that of the control group(25.58%)，and the difference was statistically significant(字2=3.957，P<0.05).There were no complications after surgery in the two groups.The patients were followed up for 36 months，there was no internal fixation loosening in the observation group.The control group screw loosening 2 cases.Conclusion：Compared with posterior cervical lateral mass screw fixation，posterior cervical pedicle screw fixation has a good therapeutic effect on multi-segmental cervical spondylotic myelopathy，which is more helpful to maintain cervical stability，and the incidence of AS decreased significantly., 百拇医药(郭建利 张芝亮 杜远立 郑之和)
【关键词】 颈后路椎弓根螺钉固定术; 颈后路侧块螺钉内固定术; 多节段脊髓型颈椎病; 临床效果
doi：10.14033/j.cnki.cfmr.2019.24.018 文献标识码 B 文章编号 1674-6805(2019)24-00-03
【Abstract】 Objective：To evaluate the efficacy of posterior cervical pedicle screw fixation and posterior cervical lateral mass screw fixation for multi-segmental cervical spondylotic myelopathy.Method：A total of 86 patients with multi-segmental cervical spondylotic myelopathy admitted to our hospital from January 2014 to May 2015 were enrolled.According to the sampling method，patients were divided into the observation group and the control group，43 cases in each group.The control group underwent posterior cervical lateral mass screw fixation.The observation group underwent posterior cervical pedicle screw fixation.The neurological recovery，cervical curvature index，cervical axial symptoms and complication rate were observed.Result：After surgery，the changes of CCI and curvature in the observation group were compared with those of the control group，and the differences were not statistically significant(P>0.05).The final follow-up CCI of the observation group was significantly lower than that of the control group，and the change of curvature of final follow-up was significantly higher than that of the control group，and the differences were statistically significant(P<0.05).The total incidence of AS in the observation group was 9.30%，which was significantly lower than that of the control group(25.58%)，and the difference was statistically significant(字2=3.957，P<0.05).There were no complications after surgery in the two groups.The patients were followed up for 36 months，there was no internal fixation loosening in the observation group.The control group screw loosening 2 cases.Conclusion：Compared with posterior cervical lateral mass screw fixation，posterior cervical pedicle screw fixation has a good therapeutic effect on multi-segmental cervical spondylotic myelopathy，which is more helpful to maintain cervical stability，and the incidence of AS decreased significantly., 百拇医药(郭建利 张芝亮 杜远立 郑之和)