摘要
目的探讨经颈椎前入路手术治疗脊髓型颈椎病的方法,总结临床经验。方法63例脊髓型颈椎病患者,于体感诱发电位监测下施行颈椎前入路椎间盘切除、椎体次全切除并椎体间融合、钛板内固定术。根据日本整形外科协会（JOA）评分及影像学改善程度,评价手术疗效。结果63例患者手术后临床症状均明显改善,无一例发生出血、瘫痪、脑脊液漏及内固定松脱、断裂等严重并发症。手术后3d和1个月JOA评分分别为（14.86±0.69）分和（15.27±0.63）分,均较手术前[（8.25±0.92）分]明显增加（P〈0.01）。影像学显示减压充分,椎体间融合良好,内固定位置准确。结论经颈椎前入路施行椎间盘切除、椎体次全切除并椎体间融合、钛板内固定术治疗脊髓型颈椎病,手术风险小,成功率高,疗效满意。
Objective To study the surgical technique and clinical experience of anterior cervical corpectomy for the treatment of cervical spondylotic myelopathy （CSM）. Methods Sixty-three patients with cervical spondylotic myelopathy were treated with anterior cervical diskectomy, subtotal cervical corpectomy, and interbody fusion and internal fixation under operating microscope. After decompression, application of intervertebral bone graft or titanium mesh filled with autogenous bone and plating fixation were performed. During the surgery, somatosensory evoked potential （SEP） was used as intraoperative monitoring （IOM）. Japanese Orthopedic Association （JOA） score and imaging were used to assess improvement degree and therapeutic effect. Results After operation, clinical features of 63 patients were improved obviously, there were no any serious complications. The patients were followed up for 6-120 months. At 3 d and 1 month after operation, the JOA scores were （14.86 ± 0.69） and （15.27 ± 0.63）, respectively, which was significantly higher than that before operation [（8.25 ± 0.92）, P 〈 0.01]. Radiological studies revealed that the spinal cord was decompressed completely, and the interbody fusion and internal fixation were all satisfactory. Conclusion The anterior cervical diskectomy, subtotal cervical corpectomy, and interbody fusion and internal fixation for the treatment of cervical spondylotic myelopathy is safe and effective. The rate of success is high.
出处
《中国现代神经疾病杂志》
CAS
2009年第2期135-139,共5页
Chinese Journal of Contemporary Neurology and Neurosurgery
关键词
颈椎病
椎间盘切除术
脊髓疾病
钛
骨折固定术
内
Cervical spondylosis
Diskectomy
Spinal cord diseases
Titanium
Fracture fixation, internal
