摘要
目的探讨脊髓型颈椎病前路和后路手术减压内固定术治疗的方法和疗效。方法对四川省人民医院2004年11月至2009年1月经前路减压及带锁钢板固定和后路减压、侧快螺钉内固定治疗脊髓型颈椎病患者64例，神经功能评价依照JOA评分法，所有病例均行颈椎常规X射线摄片及MRI检查。前路手术44例，后路手术20例。结果获得随访55例，随访时间3～48个月。获访患者植骨在3～4月内获得牢固骨融合，椎间高度和生理弯曲度得到良好的保持，无钢板和螺钉断裂等并发症的发生。手术时间和出血量比较前路少于后路，差异有显著性意义（P〈0．05）。手术有效率前路95．45％（42／44），后路95％（19／20），差异无显著性意义（P〉0．05）。结论颈椎前路减压术是治疗脊髓型颈椎病的有效术式，相对于后路手术有较高的植骨融合率，风险小，出血少。
Objective To analyze and compare the therapeutic effects of anterior and posterior operative approaches in the treatment of cervical spondylotie myelopath. Methods Among 64 cases of cervical spondylotic myelopathy hospitalized in Sichuan Provincial People＇s Hospital from Nov. 2004 to Jan. 2009,44 cases were subjected to multilevel decompression, titanium net bone graft pedestal to fuse internal fixation of anterior approach, and the remaining 20 cases to whole laminectomy for decompression, bone graft plus lateral mass bolt internal fixation of posterior approach of the spinal cord decompression section. Symptom improvement rate, bone graft fusion rate and recovery of cervical vertebra physiological camber were evaluated by JOA standard , X-ray and MRI appearance after surgery. Resutls 55 cases were followed up to 25.6 months in average. Solid fusion was ob- tained within 3 - 4 months postoperatively. The restorative of the intervertebral spaces were maintained after operation. The physiological curve of cervical spine is good. No complications occurred, such as breaking of the plate and screw. Efficient operation of anterior approach was 95.45% （42/44）, posterior 95% （19/20）. Conclusion Anterior approach decompressing is an effective therapeutic method to treat the cervical spondylotic myelopathy , bone graft fusion rate is higher, whereas surgical risk and loss of blood are less than that of posterior approach.
出处
《实用医院临床杂志》
2009年第5期88-90,共3页
Practical Journal of Clinical Medicine
关键词
脊髓型颈椎病
手术治疗
前后路减压
内固定
Cervical spondylotic myelopath
Surgical operation
Anterior or posterior decompression
Internal fixation
