摘要
目的探讨椎体次全切联合单间隙减压治疗多节段脊髓型颈椎病的效果。方法回顾性分析2005年3月至2009年10月采用椎体次全切联合单间隙减压治疗22例多节段（连续3个或4个节段）病变的脊髓型颈椎病的临床效果。术前X线片及MRI示均有不同程度椎间盘突出、骨赘形成、颈髓受压。分析术中出血量、术后6个月植骨融合率、6个月时的JOA评分改变。结果术后切口均一期愈合。患者均获随访，术后6个月随访时JOA评分均有不同程度提高，与术前比较差异有统计学意义（P〈0．05）；6个月植骨融合率为100％，所有患者的颈椎畸形矫正后曲度明显恢复，有些恢复正常。按照Odom’s临床效果分级进行评价，优18例，良3例。无植骨块延期融合、内置物下沉或移位等并发症发生。结论椎体次全切联合单间隙减压是治疗多节段脊髓型颈椎病较好的手术方式。
Objective To study the effect of subtotal vertebrectomy and segmental anterior decompression through disc space on muhilevel cervical spondylotie myelopathy （ CSM ）. Methods The therapeutic effect of 22 patients of CSM with 3 or 4 eonseeutive segments who received the treatment of subtotal vertebreetomy and anterior decompression through cervieal disc space from Mareh 2005 to October 2009 were retrospectively analyzed. X - ray films and MRI showed disc herniation and osteophytosis eompression of cervical cord preoperatively. The parameters including blood loss, graft or implants fusion rate and improvement of JOA score 6 months postoperatively were collected. Results All the incisions were healed by first intention. All the patients were followed up. In our series, JOA scores in all patients were improved 6 months after operation. The improvement rate indicated significant difference when compared with the JOA scores before operation（P 〈0.01 ）. The rate of graft bone fusion was 100%. All patients kyphotic deformity was corrected and some restored normally. According to Odom＇s evaluation scale, 18 patients were graded as excellent and 3 as good. The improvement rate indicated significant difference when compared with the Odom＇s scores before operation（P 〈 0.01 ）. No complications such as delayed graft or implants fusion and graft subsidence occurred. The cage witnessed no translocation. Conclusion Subtotal vertebrectomy and segmental anterior cervical decompression is a more stable and effective technique for multilevel cervical myelopathy.
出处
《中国医学创新》
CAS
2010年第5期23-25,共3页
Medical Innovation of China
关键词
多节段脊髓型颈椎病
椎体次全切
单间隙减压
椎间融合
Multilevel cervical spondylotic myelopathy
Subtotal vertebrectomy
Segmental decompression
Interbody fusion
作者简介
通讯作者：刘玉军
