颈人工间盘置换术与前路减压融合术治疗单节段脊髓型颈椎病的疗效比较研究

A Comparative Study of the Efficacy of Total Disc Replacement versus Anterior Cervical Discectomy and Fusion in the Treatment of Single-Segment Cervical Spinal Cord Syndrome

摘要: 随着我国人口老龄化的日益加重和目前人们生活方式的改变，目前脊髓型颈椎病的发病率已逐年上升，早已严重影响患者的日常生活质量。目前，手术治疗是其主要的治疗手段，其中颈人工间盘置换术(Total Disc Replacement, TDR)与颈前路减压融合术(Anterior Cervical Discectomy and Fusion, ACDF)是两种常见的术式。本研究旨在比较这两种术式在治疗单节段脊髓型颈椎病中的疗效差异，为临床选择提供科学依据。通过回顾性分析2020年至2025年间在我院接受TDR或ACDF治疗的单节段脊髓型颈椎病患者的临床资料，经过评估术后神经功能恢复、并发症发生率、生活质量改善情况等指标。结果显示，TDR组在术后神经功能恢复方面优于ACDF组，且术后邻近节段退变的发生率较低；但两组在术后疼痛缓解、手术时间及住院时间等方面无显著差异。此外，TDR组在术后早期活动能力方面表现更优。然而，TDR手术对术者技术要求较高，且长期随访数据仍需进一步积累。综上所述，TDR在治疗单节段脊髓型颈椎病中具有一定的优势，但其适应证需严格把握，未来应加强长期随访研究以验证其远期效果。

Abstract: Objective: With the increasing ageing of China’s population and current lifestyle changes, the incidence of cervical spondylotic myelopathy has risen annually, significantly impacting patients’ quality of daily life. Currently, surgical intervention remains the primary treatment approach, with total disc replacement (TDR) and anterior cervical discectomy and fusion (ACDF) being two common procedures. This study aims to compare the therapeutic efficacy of these two procedures in treating single-level cervical spondylotic myelopathy, providing scientific evidence for clinical decision-making. Through retrospective analysis of clinical data from patients undergoing TDR or ACDF for single-level cervical spondylotic myelopathy at our hospital between 2020 and 2025, we evaluated postoperative outcomes including neurological recovery, complication rates, and quality of life improvements. Results demonstrated superior postoperative neurological recovery in the TDR group compared to the ACDF group, alongside a lower incidence of adjacent segment degeneration. However, no significant differences were observed between groups regarding postoperative pain relief, surgical duration, or hospital stay. Additionally, the TDR group exhibited superior early postoperative mobility. Nevertheless, TDR demands higher technical proficiency from surgeons, and long-term follow-up data requires further accumulation. In summary, TDR demonstrates certain advantages in treating single-level cervical spondylotic myelopathy, though its indications must be strictly defined. Future research should focus on long-term follow-up studies to validate its long-term efficacy.