摘要
[目的]探讨采用后前路联合手术治疗重症脊髓型颈椎病（CSM）的临床效果。[方法]回顾性研究自1998年9月．2006年1月本院采用后前路联合手术治疗32例重症脊髓型颈椎病病例。其中，男20例，女12例；年龄41～78岁．平均53．8岁。发病节段：C3,4 2例，C4,5 ，9例，C5,5 11例，C6,7 10例。前路减压涉及一个椎间隙的4例，2个椎间隙一个椎体的12例，涉及3个椎间隙2个椎体以上的16例。本组所有患者均先采用颈椎后路单开门椎管成形术，1周后再行颈椎前路减压植骨或钛网植入内固定术。依据JOA评分标准，观察并记录患者的神经功能恢复情况，比较手术前、术后随访时JOA评分，评价临床治疗效果。[结果]所有患者定期随访，随访时间12～18个月（平均13．6个月），术前患者JOA评分为（6．51±1．10）分，一期术后JOA评分为（9．47±0．55）分，随访时JOA评分为（12．42±0．79）分，采用配对t检验对术前、术后随访时JOA评分进行统计学分析，有显著性差异（P〈0．001，a=0．05），后前路联合手术改善率为（56．37±5．58）％。[结论]后前路联合手术为复杂的重症脊髓型颈椎病手术治疗提供了一种比较安全、可靠的方法。可提高CSM临床改善率，减少并发症发生。
[ Objective] To explore the therapeutic effect of the posterior-anterior approach surgical treatment for severe cervical spondylotic myelopathy. [ Method] Totally 32 patients with severe cervical spondylotic myelopathy operated by posterior-anterior approach surgical treatment from September in 1998 to January in 2005 were retrospectively analyzed. In the 32 patients, 20 males and 12 females. Their age averaged 53. 8 years （ranged, 41 -78 years）, invasional segments： C3,4 2 cases, C4.5 9 cases, C5.6 11 cases, C6,7 10 cases. Four cases with lesions involving one intervenebral space, the other 12 and 16 cases involving two and three intervertebral spaces respectively. All cases had the posterior cervical open-door laminoplasty decompression in first, and had the anterior cervical decompression and bone grafting or fusion with titanium Cage internal fixation after a week. To follow up all the postoperative cases, neural function was recorded. According to JOA score, preoperative score and postoperative follow-up score were compared, improvement rates were caleulated respectively. [ Result ] All cases were regularly followed up. The duration of follow-up averaged 13.6 months （ ranged, 12 - 18 months） . The JOA of before operation was （ 6. 51 ± 1.10）, the JOA of first period of time after operation was （ 9. 47 ± 0. 5 ）, and follow-up JOA was （ 12.42 ± 0. 79）. T- test was used to compare pre-operative and follow-up JOA scores. The statistical results were significantly different （P 〈0. 001, a = 0. 05）. The improvement rate of posterior-anterior unites to cure the severe cervical spondylotic myelopathy was （56.37 ± 5.58） %. [ Conclusion] The posterior-anterior approach surgical treatment for complicated severe cervical spondylotic myelopathy is able to raise the clinical improvement rate and to reduce the occurrence of the complications.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第5期344-346,共3页
Orthopedic Journal of China
关键词
重症脊髓型颈椎病
手术方法
临床疗效
severe cervical spondylotic myelopathy
operative treatment
clinical effect
