摘要
目的分析单椎体次全切颈椎融合结合相邻节段人工颈椎间盘置换(CADR)治疗三节段颈椎病的临床疗效及影像学结果。方法回顾性分析自2008年6月～2011年3月采用经颈前路单椎体次全切除,钛网植骨融合带锁钛板内固定(ACCF),结合相邻单节段椎间盘切除Modi-c人工颈椎间盘置换手术(CADR)治疗19例三节段颈椎病。结果本组平均随访26.5个月(12～36个月),融合节段均得到骨性融合。术前JOA评分(9.6±1.7)分,末次随访为(14.4±1.1)分(P<0.05),末次随访JOA评分平均改善率为70.1%。术前VAS评分(7.1±1.1)分,术后(1.0±0.7)分(P<0.05);术前NDI(40.4±3.7)分,末次随访降至(9.3±2.2)分(P<0.05)。人工颈椎间盘置换节段术前活动度为(16.0±3.3)°,末次随访时(15.6±3.1)°(P>0.05)。结论采用人工颈椎间盘置换结合颈椎融合术治疗三节段颈椎病,有效可行,减压彻底,保留了部分手术节段的运动功能,减少术后相邻节段出现退变的可能。
Objective To investigate the clinical effects and radiographic outcomes of anterior cervical corpectomy and fusion （ACCF） combined with cervical artificial disc replacement（CADR） for three consecutive segments cervical myelopathy（TCSCM）. Methods Between June 2009 and May 2009, 19 cases of TCSCM were treated with ACCF combined with CADR by Mobi-C prosthesis. Results No perioperative and postoperative complications were found. All cases were followed up for 26.5 months on average （range, 12～36 months）. The rate of graft bone fusion was 100%. JOA score at last follow-up （14.4±1.1） was significantly higher than preoperative （9.6±1.7） （P 〈0.05）, and the improvement rate at last follow-up was 70.1%. VAS score at last follow-up （1.0±0.7） had significant difference when compared with preoperative one （7.1±1.1） （P 〈0.05）. NDI score at last follow-up （9.3±2.2） had significant difference when compared with preoperative one （40.4±3.7） （P 〈0.05）. Conclusion ACCF combined with CADR can be an effective and feasible treatment for patients with TCSCM. It can apply effective decompression, retain part of motor function of the surgical segment, and reduce postoperative adjacent disk degeneration.
出处
《中国骨与关节损伤杂志》
2013年第1期1-3,共3页
Chinese Journal of Bone and Joint Injury
关键词
颈椎病
脊柱融合术
人工颈椎间盘
多节段
Cervical myelopathy
Spinal fusion
Cervical artificial disc
Muhilevel
