摘要
目的探讨脊髓型颈椎病的手术治疗方式和早期疗效。方法54例脊髓型颈椎病患者,前路显微镜下手术减压及椎间植骨融合颈前路钛钢板内固定术50例,前路脊柱内镜下手术减压及椎间植骨融合颈前路钛钢板内固定术2例,前路显微镜下减压后椎间植Bryan人工椎关节盘2例。结果随访进行6～48个月(平均25个月),症状明显缓解,脊髓功能明显改善者52例,占96.3%。52例植骨者术后6个月植骨融合率100%。2例Bryan人工椎关节盘植入者,术后6个月及1年X线平片随访显示:颈椎过曲、过伸运动及生理曲度良好,与自体椎体融合良好。术后症状与术前比较无明显缓解但无加重者2例。结论对脊髓型颈椎病,前路手术不同方式各有其适应证,应根据临床表现、体征、影像学特征早期诊断和尽早手术,进行仔细的显微操作技术,可以更加充分减压并减少对脊髓的损伤,取得更加良好的治疗效果。
Objective To analyze the surgical procedure and short-term outcome and prognosis. Methods We performed anterior cervical microdiskectomies on cervical spondylotic myelopathy of the 54 patients. Of 54 cases, 50 ACD microsurgically with auto iliac graft implant and titanium plating, 2 ACD endoscopically with auto iliac graft implanting and titanium plating, 2 ACD with Bryan cervical disk implanting were performed. Results During 6 - 48 （average 25 months） months＇ follow-up, 52 patients （96. 3% ） got improved neurologically, 52 cases with auto iliac graft implanting got fusion rate 100% during 6 months＇ follow-up. 2 patients with Bryan cervical disk implanting kept good cervical spine movement, got a good curvature lordosis on extension and flexion X-ray film 6 months after surgery. 2 patients with ACD remained stable neurologically after surgery. Conclusions Early diagnosis and adequate surgical decompression is helpful to most patients with cervical spondylotic myelopathy. Intensive microsurgical procedures will beneficial to protecting the spinal cord and improve the outcomes.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2007年第5期272-275,共4页
Chinese Journal of Nervous and Mental Diseases
