摘要
目的 比较脊髓型颈椎病前路和后路外科手术的疗效 ,分析影响疗效的预后因素。方法 对 1 0 6例前后路减压后脊髓型颈椎病患者通过信函、电话采访和复诊等方式进行了随访 ,平均随访时间为 38个月 (5～ 84个月 ) ,平均术前症状时间为 2 6个月 (5～ 79个月 ) ,年龄分组为大于 55岁组和小于 55岁组 ;按照JOA评分系统评价术前和术后神经功能状态。结果 术前症状时间与恢复率有显著相关性 (R =0 . 544) ,术后 1个月 76例前路手术患者 ,61例有改善 ;30例后路手术患者 2 7例有改善 ,最后 1次随访前路 57例有改善 ,后路 2 1例有改善 ,年龄组间的症状时间、下肢症状时间和术后JOA评分有显著差异。结论 前、后路手术在早期均有好的疗效 ,其疗效在晚期呈进行性下降 ,脊髓型颈椎病需要手术治疗。
Objective To compare the surgical outcome of anterior and posterior approach for cervical spondylotic myelopathy(CSM).And to analyse various predictions of surgical outcome.Methods One hundred and six patients with cervical spondylotic myelopathy were followed up by postoperative letters,telephone interviews or reviewing.The median following-up duration was 38 months(ranged 5～84 months).The average duration of preoperative symptoms was 26 months(rangs 5～79 months).The age was divided into two parts:more or less than 55.Functional improvement was evaluated by using the Japanese Orthopedic Association Scale(JOA scale)comparing postoperation with preoperation.Results The duration of preoperative symptoms was correlated significantly with the recovery rate(R=0.544).One month after operation,symptoms in 61 of 76 patients who received anterior approach were alleviated,while 27 of 30 patients in posterior approach for CSM.At the last follow-up time,symptoms alleviation was 57 patients in anterior approach and 21 patients in posterior approach.The duration of symptoms,the duration of symptoms in lower extremities and postoperative JOA scale were different significantly in two parts divided by age.Conclusion The curative effect is splendent in two sorts of operation at early time of CSM,but decreases progressively at late time.And the patients who have CSM need operation.
出处
《骨与关节损伤杂志》
2002年第1期11-13,共3页
The Journal of Bone and Joint Injury
关键词
脊髓型颈椎病
前路减压
后路减压
预后因素
治疗
比较
外科手术
Cervical spondylotic myelopathy
Anterior cervical decompression
Posterior cervical decompression
Predictions of surgical outcome
