摘要
目的探讨颈椎前入路减压、钢板内固定术治疗脊髓型颈椎病的手术方法及临床疗效。方法32例脊髓型颈椎病患者施行颈椎前入路减压、钛网植骨、带锁钢板内固定术,日本整形外科协会（JOA）评分评价神经功能改善情况。结果32例患者手术中无一例死亡。随访9～38个月,平均19个月,28例临床症状明显缓解,脊髓功能改善;其余4例无改变。手术后神经功能达优者19例（59.38%）,良者9例（28.13%）,中者3例（9.38%）,差者1例（3.13%）。手术后JOA评分为（16.56±3.17）分,与手术前的（9.13±2.27）分比较,差异具有统计学意义（t=2.370,P=0.027）。结论经颈椎前入路减压、钢板内固定术治疗脊髓型颈椎病具有固定、稳定手术椎体节段和诱导成骨形成的作用,手术后颈椎获得即刻稳定,椎体间融合良好。但手术疗效与病变累及范围和病程有关,强调早期手术治疗以达到最佳疗效。
Objective To explore the surgical procedure and therapeutic efficiency of anterior cervical decompression （ACD） and steel plate internal fixation for cervical spondylotic myelopathy （CSM）. Methods Thirty-two patients with CSM were treated with anterior cervical decompression, titanium mesh implant combined with internal fixation of locking steel plate. Examinations were performed before and after operation. Improvement degree was evaluated by post-operative X-ray, self-sensation and Japanese Orthopedic Association （JOA） score. Results During operation no death occurred. All patients were followed up for 9-38 months （19 months in average） after operation. In 28 cases the clinical symptoms obviously remitted and spinal function significantly improved. After operation, neural function improvement was excellent in 19 cases （59.38%）, good in 9 cases （28.13%）, medium in 3 cases （9.38%） and ineffective in one case （3.13%）. JOA score improved from （9.13 ± 2.27） to （16.56 ± 3.17）, the difference was significant （t = 2.370, P = 0.027）. Con- clusion Anterior cervical decompression and steel plate internal fixation for cervical spondylotic myelopathy is benefical to fix and stabilize the operated vertebrae segments, and can induce osteogenesis. After operation, the cervical vertebrae can be instantly stabilized quite well, and the interbody fusion is well. The surgical efficiency of anterior cervical decompression and steel plate internal fixation for cervical spondylotic myelopathy is related to the involved lesion area and the course of disease. It should be emphasized to perform early surgical intervention for achieving satisfactory outcome.
出处
《中国现代神经疾病杂志》
CAS
2009年第2期140-144,共5页
Chinese Journal of Contemporary Neurology and Neurosurgery
基金
四川省杰出青年学科带头人培养计划项目(项目编号:303005002141)
关键词
减压术
外科
脊髓疾病
颈椎病
椎间盘切除术
钛
Decompression, surgical
Spinal cord diseases
Cervical spondylosis
Diskectomy
Titanium
