摘要
目的探讨多节段颈椎病手术治疗方案的选择及前路手术的临床应用价值。方法对132例多节段颈椎病患者,采用前路手术方法治疗113例,后路手术方法治疗11例,前后路联合手术方法治疗8例。观察患者神经功能改善、颈椎椎间高度和颈椎生理曲度恢复和重建。结果所有患者术后JOA评分均有改善,前路手术方法治疗组JOA改善率为58.5%,后路手术方法治疗组54.6%;前后路联合方法治疗组56.8%;各手术组患者颈椎Cobb角、D值术后与术前比较均有显著性差异(P<0.01);椎间高度前路手术方法术后与术前比较有显著性差异(P<0.01),后路手术方法术后与术前比较差异无统计学意义(P>0.05);前路与后路Cobb角、D值、椎间高度差值比较有显著性差异(P<0.01)。结论多节段颈椎病患者的手术治疗能显著改善其神经功能,颈前路手术方法椎间高度及生理曲度恢复和重建优于颈后路手术方法。
Objective To study the choice of surgical methods and the clinical value of anterior approach for multilevel cervical spondylosis. Methods One hundred and thirty-two cases of multilevel cervical spondylosis were treated surgically, including 113 cases by anterior approach, 11 cases by posterior approach and 8 cases by anterior combined with posterior app-reach. The improvement of neurological function, the restoration and reconstruction of the lordosis and intervertebral height of cervical spine were observed. Results Neurological function of all the cases was improved according to JOA score. The improvement rate of anterior approach was 58.5%, posterior approach 54.6% and combined approach 56.8%. There were significant differences between preoperative and immediately postoperative in Cobb angle and D value of all the groups and intervertebral height of anterior approach group （ P 〈0. 01 ）, and there ivas no significant difference between preoperative and postoperative in posterior approach group （ P 〉0.05）. There were significant differences between anterior approach and posterior approach in Cobb angle, D value and intervertebral height （ P 〈0.01）. Conclusion Surgical treatment of multilevel cervical spondylosis can significantly.improve the neurological function, and anterior approach can obtain a better outcome than posterior approach in the restoration and reconstruction of the lordosis and intervertebral height of cervical spine.
出处
《脊柱外科杂志》
2006年第1期25-28,共4页
Journal of Spinal Surgery
关键词
颈椎
内固定器
脊柱融合术
外科减压术
cervical vertebrae
internal fixators
spinal fusion
surgical decompression
