摘要
目的探讨颈椎前路分节段减压术治疗多节段脊髓型颈椎病的手术方法及疗效。方法 2003年12月至2008年12月采用前路分节段减压术治疗多节段脊髓型颈椎病患者48例,男25例,女23例;3节段病变39例,4节段9例;术中采用1个椎体次全切除加1或2个椎间隙减压,同时行植骨融合钛板固定,术后定期复查颈椎正侧位及屈伸位X线片,观察植骨融合情况,采用JOA评分评价神经功能。结果手术时间70～220min,平均87min,术中出血量120～800 ml,平均210 ml。全部获得随访,术后随访12～60个月,平均26个月,所有病例均获骨性融合,融合时间3～9个月,平均6.2个月。术前JOA评分为(6.3±3.2)分,末次随访时JOA评分为(13.2±3.6)分,与术前比较有显著性差异(P<0.01),改善率为72.8%±16.2%,优良率为89.6%。结论颈椎前路分节段减压术是治疗多节段脊髓型颈椎病的一种可靠术式,可获得理想的植骨融合率及神经功能改善率。
Objective To explore the method of operation and the clinical efficacy of anterior noncontiguous corpectomies decompression for multilevel cervical spondylotic myelopathy.Methods From December 2003 to December 2008, 48 patients（25 males,23 females） underwent anterior noncontiguous corpectomies decompression for multilevel cervical spondylotic myelopathy.All of them（39 3 - levies,9 4 - levies） underwent bone graft with titanium mesh cage and segmental plate fixation after 1-level/2 - levels discectomy combined with 1 - level corpectomy.Postoperatively,JOA scores was adopted to evaluate neural function and radiography was adopted to observe the fusion of bone graft.Results The average operative time was 87 min（range 70 to 220min）,the average blood loss was 210ml（range 120 to 800ml）.All cases were followed up for 12～60 months（average 26 months）.Bony union was achieved in all the patients with average union time of 6.2 months（3-9 months）.The average JOA scores increased from preoperative 6.3±3.2 to postoperative 13.2±3.6,significant difference of JOA score was observed between preoperation and postoperation.The total excellent and good rate is 89.6%and improvement rate is 72.8%±16.2%.Conclusion The treatment of anterior noncontiguous corpectomies decompression for multilevel cervical spondylotic myelopath is a reliable method with satisfied fusion rate and improvement of neural function.
出处
《中国骨与关节外科》
2010年第6期442-445,共4页
Chinese Journal of Bone and Joint Surgery
关键词
脊髓型颈椎病
分节段减压术
前路
Cervical spondylotic myelopathy
Noncontiguous corpectomies decompression
Anterior approach
