2026 年第 7 期 第 21 卷

神经根型颈椎病患者颈椎前路椎间盘切除植骨融合术后康复效果研究分析

Study and analysis of rehabilitation effect in patients with cervical spondylotic radiculopathy after anterior cervical discectomy and fusion

作者：顾晓凯范建平

英文作者：Gu Xiaokai Fan Jianping

单位：海军军医大学第二附属医院脊柱微创科，上海200003

英文单位：Department of Minimally Invasive Spine Surgery the Second Affiliated Hospital of Naval Medical University Shanghai 200003 China

关键词：神经根型颈椎病；颈椎前路椎间盘切除植骨融合；康复效果

英文关键词：Cervicalspondyloticradiculopathy;Anteriorcervicaldiscectomyandfusion;Rehabilitationeffect

• 摘要：

• 目的 探讨神经根型颈椎病（CSR）患者颈椎前路椎间盘切除植骨融合（ACDF）术后康复效果并分析其影响因素。方法 回顾性分析海军军医大学第二附属医院2020年6月至2024年6月收治的142例行ACDF治疗的CSR患者的临床资料。术后随访3个月，通过神经根型颈椎病康复评价量表（RES-CSR）评估术后康复效果，应用多元线性回归分析术后康复效果的影响因素，使用多元线性回归中的乘积项检验法进行因素间的交互作用分析。结果 142例CSR患者ACDF术后3个月RES-CSR评分为（77±15）分，处于中等康复水平。多元线性回归分析结果显示，年龄≥65岁（β=-0.160，P=0.001）、糖尿病（β=-0.120，P=0.002）、运动锻炼强度＜3次/周（β=-0.229，P＜0.001）、合并焦虑/抑郁（β=-0.199，P＜0.001）、术后1个月日本骨科协会（JOA）评分＜12分（β=-0.268，P＜0.001）、术后并发吞咽困难（β=-0.197，P＜0.001）均是影响ACDF术后康复效果的独立危险因素。各危险因素对康复效果的影响不存在显著的交互效应。结论 CSR患者ACDF术后整体康复效果中等，年龄、糖尿病、运动锻炼强度、焦虑/抑郁情绪、术后1个月JOA评分、并发吞咽困难是影响术后康复的核心因素，根据影响因素实施针对性干预方案，有助于提升术后康复质量。

• Objective To investigate the rehabilitation effect and its influencing factors in patients with cervical spondylotic radiculopathy (CSR) after anterior cervical discectomy and fusion (ACDF). Methods Clinical data of 142 CSR patients treated with ACDF in the Second Affiliated Hospital of Naval Medical University from June 2020 to June 2024 were retrospectively analyzed. All patients were followed up for 3 months postoperatively. The rehabilitation effect was evaluated using the rehabilitation evaluation scale for cervical spondylotic radiculopathy (RES-CSR). Multiple linear regression was used to analyze the influencing factors of postoperative rehabilitation effect, and the product term test in multiple linear regression was used to analyze the interaction between factors. Results The RES-CSR score of 142 CSR patients at 3 months after ACDF was 77±15, indicating a moderate rehabilitation level. Multiple linear regression analysis showed that age ≥65 years (β=-0.160, P=0.001), diabetes mellitus (β=-0.120, P=0.002), exercise intensity <3 times/week (β=-0.229, P<0.001), comorbid anxiety/depression (β=-0.199, P<0.001), Japanese Orthopaedic Association (JOA) score < 12 at 1 month postoperatively (β=-0.268, P<0.001), and postoperative dysphagia (β=-0.197, P<0.001) were independent risk factors affecting the rehabilitation effect after ACDF. There was no significant interaction effect of these risk factors on rehabilitation outcome. Conclusion The overall rehabilitation effect of CSR patients after ACDF is moderate. Age, diabetes mellitus, exercise intensity, anxiety/depression, JOA score at 1 month postoperatively, and dysphagia are core factors affecting postoperative rehabilitation. Targeted intervention strategies based on these factors can help improve the quality of postoperative rehabilitation.