不同手术方式对多节段脊髓型颈椎病患者治疗效果和预后的影响

doi:10.3969/j.issn.1006-6233.2023.06.028

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Abstract Objective: To analyze the effects of anterior-posterior approach and simple posterior approach on the clinical curative effect, quality of life and postoperative complications in patients with multi-level cervical spondylotic myelopathy and optimize the surgical treatment. Methods: One hundred and twenty patients with multi-segmental spinal cord type cervical spondylosis were collected from our hospital between January 2016 and December 2021, and were divided into the posterior-only group (n=83) and the combined anterior-posterior group (n=37) according to the different surgical approaches. The duration of surgery, bleeding, length of hospital stay and hospital costs were recorded for both groups; the recovery of neurological function and quality of life at 1, 3 and 12 months after surgery were assessed by JOA, VRS and NRS scores and PF, RP and GH rating scales; patient satisfaction was recorded by telephone follow-up. Results: Compared with the posterior group, there were no statistical differences in JOA scores, JOA recovery rates, PF, RP, GH scores and satisfaction among patients with combined anterior and posterior surgery at each postoperative follow-up time point (P>0.05); NDI scores were significantly higher in the combined anterior and posterior group at 3 and 12 months postoperatively, with a statistical difference (P<0.05); VRS and NRS scores were statistically higher in the combined anterior-posterior group than in the posterior-only group (P<0.05); the incidence of postoperative axial symptoms was significantly higher in the combined anterior-posterior group (P<0.05); and the duration of surgery, intraoperative blood loss, postoperative hospital stay and hospital costs were significantly higher in the combined anterior-posterior group (P<0.01). NDI scores were statistically higher in the combined anterior-posterior group of K-line negative patients at 1 and 12 months postoperatively compared to the posterior-only group of K-line negative patients (p<0.05). Conclusion: Combined anterior and posterior surgery does not offer significant advantages in terms of neurological recovery, improvement in quality of life and patient satisfaction, but rather entails greater surgical trauma, cost and complications.

Key words： Multi-segmental spinal cord cervical spondylosis Posterior-only approaches Combined anterior-posterior approaches Complication Satisfaction

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	SHEN Yuan
	YU Honghao
	YUAN Quan

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SHEN Yuan,YU Honghao,YUAN Quan. Effect of Different Surgical Approaches on the Treatment Outcome and Prognosis of Patients with Multi-Segmental Spinal Cord Cervical Spondylosis[J]. HeBei Med, 2023, 29(6): 1026-1031.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.06.028 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I6/1026

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