两种术式治疗多阶段神经根型颈椎病的近期疗效比较

Comparison of Recent Efficacy of Two Surgical Techniques for Multi-Stage Radiculopathy Cervical Spondylosis

摘要: 目的：评价颈椎前路椎间盘切除减压融合术(ACDF)和颈椎前路椎体次全切除减压融合术(ACCF)治疗多阶段神经根型颈椎病(CS)的临床疗效。方法：收集我院脊柱外科2022年2月~2023年2月因多阶段神经根型颈椎病采用ACDF与ACCF治疗的80例患者临床资料，根据不同手术方式，分为ACDF组40例，ACCF组40例。收集并比较两组手术时间、术中出血量、术后引流量、下床时间及住院时间，比较两组疼痛缓解情况、颈椎功能恢复情况及不良事件发生情况。结果：所有患者手术顺利，ACDF组手术时间较ACCF组明显减少，((134.45 ± 7.60) min vs. (153.63 ± 4.36) min, P < 0.001)；ACDF术中出血量较ACCF组明显减少，((55.02 ± 8.45) ml vs. (70.65 ± 8.07) ml, P < 0.001)；ACDF组术后引流量较ACCF组明显减少，((217.36 ± 13.65) ml vs. (259.62 ± 8.52) ml, P < 0.001)；ACDF组下床时间较ACCF组明显减少，((2.72 ± 0.50) d vs. (3.87 ± 0.70) d, P < 0.05)；ACDF组住院时间较ACCF组明显减少，((7.26 ± 1.34) d vs. (10.86 ± 0.94) d, P < 0.001)；两组患者疼痛缓解情况、颈椎功能恢复情况及不良事件发生情况未见明显差异(P > 0.05)。结论：ACDF与ACCF两种方法在治疗多阶段神经根型颈椎病方面的效果未见显著差异，然而，ACDF手术具有更短的手术时间以及更少的出血量，因此更适合于手术耐受性较低的患者群体。

Abstract: Objective: To evaluate the clinical efficacy of anterior cervical discectomy (ACDF) and subtotal anterior cervical vertebra (ACCF) in the treatment of multistage cervical spondylotic opathy (CS). Methods: The clinical data of 80 patients treated with ACDF and ACCF due to multi-stage radiculopathy from February 2, 2022 to February 2, 2023, which were divided into 40 patients in ACDF and 40 in ACCF according to different surgical methods. The operation time, intraoperative blood loss, postoperative drainage rate, implantation time and hospitalization time were collected and compared between the two groups, and the pain relief, cervical function recovery and occurrence of adverse events were compared between the two groups. Results: In all patients, surgical time was significantly reduced in the ACDF group compared with the ACCF group, ((134.45 ± 7.60) min vs. (153.63 ± 4.36) min, P < 0.001); ACDF intraoperative bleeding volume decreased significantly compared with the ACCF group, ((55.02 ± 8.45) ml vs. (70.65 ± 8.07) ml, P < 0.001); The postoperative drainage rate was significantly reduced in the ACDF group compared with the ACCF group, ((217.36 ± 13.65) ml vs. (259.62 ± 8.52) ml, P < 0.001); Sleeping time was significantly reduced in the ACDF group compared with the ACCF group, ((2.72 ± 0.50) d vs. (3.87 ± 0.70) d, P < 0.05); There was a statistically significant difference in length of stay between ACDF and ACCF groups, ((7.26 ± 1.34) d vs. (10.86 ± 0.94) d, P < 0.001); There was no significant difference in pain relief, cervical spine function recovery, and adverse events in the two groups (P > 0.05). Conclusion: No significant difference was found between the effects of ACDF and ACCF in treating multi-stage radiculopathy; however, ACDF surgery has shorter operative time and less blood loss, and thus is more suitable for the patient population with lower surgical tolerance.