伴随眩晕颈椎病的前路椎间盘切除融合

Anterior cervical discectomy and fusion for cervical spondylosis accompanied with vertigo

摘要:

[目的]探讨颈椎前路椎间盘切除融合术(anterior cervical discectomy and fusion, ACDF)治疗伴随眩晕症状颈椎病患者的临床疗效与颈椎影像学参数变化的相关性。[方法]回顾性分析 2017 年 7 月—2019 年 7 月本院行 ACDF 治疗的颈椎病伴随眩晕症状 32 例患者的临床资料。分析患者手术前后眩晕症状与影像学相关参数的相关性。[结果]所有患者均顺利完成手术，术中无神经、血管损伤等严重并发症。平均随访时间(28.45±2.87)个月，术后随时间推移，患者 DHI、NDI 评分均显著降低(P＜0.05)， 而 JOA 评分显著增加(P＜0.05)。影像学方面：椎间隙撑开高度平均为基准高度的 119.3%。术后患者椎间隙高度、椎管面积、C2~7前凸角均显著改善(P＜0.05)。手术前后责任节段平均椎管面积变化量与 DHI 评分变化值呈显著正相关(P＜0.05)。[结论]ACDF 手术可有效治疗颈椎病及其伴随的眩晕症状，适度撑开椎间隙高度，并增加颈椎曲度；眩晕症状改善与椎管面积的增加呈正相关。

Abstract:

[Objective] To investigate the clinical efficacy of anterior cervical discectomy and fusion (ACDF) for cervical spondylosis accompanied by vertigo, and the correlation between the vertigo and cervical imaging parameters. [Methods] A retrospective study was done on 32 patients who received ACDF for cervical spondylosis complicated with vertigo in our hospital from July 2017 to July 2019. The relationships between vertigo and imaging parameters were analyzed. [Results] All patients had surgical procedures completed successful- ly, and followed up for (28.45±2.87) months on an average. At the last follow-up, the DHI score, JOA score, and NDI score were significant- ly improved compared with those before surgery (P＜0.05) . Radiographically, C2~7 lordosis angle, intervertebral space height, and spinal ca- nal area significantly improved postoperatively compared with those before surgery (P＜0.05) , with the average distraction height of the in- tervertebral space of 119.3% compared with the baseline height. As result of correlation analysis, the pre-postoperative variation of DHI score proved significantly positively correlated to pre-postoperative variation of spinal canal area (P＜0.05) . [Conclusion] ACDF surgery does effectively treat cervical spondylosis accompanied with vertigo, with moderately expanded height of the intervertebral space, and in- creased cervical curvature. However, the improvement of vertigo symptoms is positively correlated with the increase of spinal canal area.