摘要
目的 探讨“跳跃型”多节段脊髓型颈椎病的病情特点与治疗方法。方法 16例“跳跃型”多节段脊髓型颈椎病患者 ,男性 11例 ,女性 5例 ,平均年龄 5 3 4岁 ,平均病程 14个月 ,病变累及跳跃的 2个功能节段者 11例 ,累及跳跃的 3个功能节段者 5例 ,术前JOA评分为 8 1分。对于跳跃一个节段累及 2个功能节段的病例采用受累节段减压融合 +跳跃节段融合 +内固定 ,对于累及 2个节段以上或跳跃间隙大于 2个节段者采用受累节段减压融合 +头颈胸石膏外固定。结果 16例获平均 18个月随访 ,手术有效率 93 8% ,优良率 6 8 7% ,术后JOA评分平均为 14 5分 ,所有病例均获骨性融合 ,无假关节形成。结论 跳跃型多节段脊髓型颈椎病病情复杂 ,采用多节段减压融合 +内固定或可靠的外固定 ,可获良好治疗效果。
Objective To study the characteristic in diagnosis and treatment of jumping multilevel cervical spondylostic myelopathy (CSM).Methods Sixteen cases of CSM patients,including 11 men and 5 women with an mean age of 53 4 years and with an average time of 14 months after occurrence of symptoms.The pathological segment in 11 cases involved two level.The other 5 cases involved three levels.The JOA score was 8.1 points preoperatively.As for these cases,the pathological segments jumped a level and involved two levels,decompression of anterior cervical spinal cord and bone-graft fussion simultaneensly in pathological segments and internal fixation were done.The other cases,involved two levels or jumped two levels at least, were treated by decompression with bone-graft fusion and cast.Results All patients were followed up with an average of 18 months,effective rate was 93.8%,excellent and good results 68.7%.The JOA score improved from 8 1 in preoperation to 14 in postoperation.Solid fusion were obtained postoperatively.Conclusion Symptoms of jumping multlevel CSM are complicate.Its curative effect is satisfactory by multilevel decompression with bone-graft fusion and internal fixation,or external fixation.
出处
《骨与关节损伤杂志》
2002年第2期104-106,共3页
The Journal of Bone and Joint Injury
