摘要
目的探讨颈椎多节段退行性疾病的前后路手术治疗方法的选择,比较临床随访结果和分析并发症发生机制。方法对60例多节段颈椎病手术前后资料进行回顾性分析,术前JOA评分为5~12分,平均为(7.9±1.5)分,采用日本矫形外科学会(JOA)评分标准及可视疼痛评分(VAS)评价术后随访结果。结果JOA评分由术前的(7.9±1.5)分提高到随访时(12.9±3.1)分,P<0.01。其中优37例(61.7),良14例(23.3),可6例(10),差3例(5)。术后顽固性颈肩痛(轴性症状)5例,经对症治疗后缓解。术后均无神经症状加重现象。结论对于多节段颈椎病,颈前路椎管减压植骨融合术和后路单开门桥形植骨融合术均是直接有效的手术方式,但在手术方法的选择上,仍应结合临床资料具体分析,设计合适的手术方式,避免并发症的出现,最终可获得良好的手术疗效。
Objective To study the anterior and posterior operation approaches for the multilevel cervical spondylotic myelopathy and to compare the clinical results and mechanism of complication in follow- up. Methods The preoperative and postoperative data of 60 patients with multilevel cervical spondylotic myelopathy were reviewed. The follow- up ranged form 6 months to 8 years. The clinical resuits were evaluated by JOA score and VAS score. Results The JOA score improved from preoperative 7.3 ± 1.5 to postoperative 12.2 ±3.0 (P〈0.01). Among them the excellent result was achieved in 37 patients (61.7%), good in 16 (26.7%), accepted in 6 (10%) and bad in 2 (5 % ). Conclusion Both anterior approach and posterior approach are predominantly effective in the treatment of multilevel cervical spondylotic myelopathy. However, the appropriate method should be selected according to the clinical details to avoid the complications and reach the best operation results at last.
出处
《中国骨与关节损伤杂志》
2008年第9期708-710,共3页
Chinese Journal of Bone and Joint Injury
关键词
颈椎疾病
椎体融合术
前路减压
Cervical myelopathy
Vertebral fusion
Anterior decompression