| 颈前路术中钩椎关节切除减压治疗神经根型颈椎病的疗效分析 |
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投稿时间：2012-06-18
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| 期刊信息：《中国骨伤》2012年，第25卷，第9期，第721-725页 |
| DOI：10.3969/j.issn.1003-0034.2012.09.005 |
| 基金项目: |
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中文摘要:
目的：分析颈前路术中钩椎关节切除减压治疗神经根型颈椎病的临床疗效.
方法：对2007年1月至2009年12月收治的56例神经根型颈椎病患者进行回顾性分析,其中男33例,女23例;年龄41～72岁,平均(58.83±8. 01)岁;病史5～48个月,平均(14.09±8.54) 个月.手术方法为颈前路椎体次全切减压植骨融合术,术中予以双侧钩椎关节切除减压.分析内容为围手术期指标(包括住院天数、失血量、手术时间),影像学改变(包括椎体高度、前凸角和术后植骨融合率)、神经功能情况(JOA评分改善情况).
结果：所有患者获得随访,时间12～30个月,平均18.2个月.患者的住院天数、失血量、手术时间分别为(4.42±0.25) d、(195.51±23.67) ml、(145.52±28.29) min.椎体高度术前、术后1年分别为(5.19±0.03) cm和(5.37±0.29) cm,差异无统计学意义(P > 0.05);前凸角从术前(1.53±0.03)°增加到术后1年的(7.78±0.66)°(P < 0.01),术后1年植骨融合率96.5%.术前JOA评分为8.69±2.13,术后1年随访时提高到15.58±2.45(P < 0.001).根据JOA评分标准进行疗效评定：优20例,良28例,可7例,差1例.
结论：颈前路术中钩椎关节切除减压手术安全、可行,适用于伴有根管狭窄和钩椎关节骨赘增生的颈椎病患者. |
| 【关键词】颈椎病 减压术,外科 脊柱融合术 |
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| Analysis of clinical effects of uncovertebral joints resection and decompression for the treatment of cervical spondylotic radiculopathy through anterior approach |
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ABSTRACT
Objective: To analyze the clinical and radiologic outcomes of bilateral uncovertebral joints resection and decompression in treating cervical spondylotic radiculopathy through anterior approach.
Methods: From January 2007 to December 2009,the clinical data of 56 patients with cervical spondylotic radiculopathy undergoing sugical treatment were retrospectively analyzed. There were 33 males and 23 females with an average age of (58.83±8.01) years (ranged,41 to 72). The course was from 5 to 48 months with an average of(14.09±8.54) months. All patients underwent bilateral uncovertebral joints resection,vertebral canal decompression and fusion through anterior approach. Perioperative,radiologic,nerve functional parameters were analyzed before and after operation. Perioperative parameters included hospital stay days and blood loss volume and operative time;radiologic parameters included vertebral height and lordosis angle and fusion rate;and according to JOA score to evaluate the nerve function.
Results: All patients were followed up from 12 to 30 months with an average of 18.2 months. Hospital stay days,blood loss volume and operative time were(4.42±0.25) d,(195.51±23.67) ml and (145.52±28.29) min,respectively. Preoperative vertebral height was(5.19±0.03) cm,and postoperative 1 year arrived to(5.37±0.29) cm,there was no significant difference between preoperative and postoperative(P > 0.05). Lordosis angle increased from preoperative (1.53±0.03)° to (7.78±0.66)°at the 1 year after operation (P < 0.01). Fusion rate was 96.5% at the 1 year after operation. JOA score increased from preoperative 8.69±2.13 to 15.58±2.45 at the 1 year after operation(P < 0.001). According to standard of JOA scoring,20 cases were excellent,28 good,7 fair and 1 poor.
Conclusion: Uncovertebral joints resection and decompression through anterior cervical approach in treating cervical spondylotic radiculopathy is safe and reliable,which can get satisfactory clinical outcomes. This surgical procedure is suitable for the patients of cervical spondylosis,especially combined canal stenosis and osteophytosis of the uncovertebral joint. |
| KEY WORDS Cervical spondylosis Decompression,surgical Spinal funsion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 袁健东,陈鑫,刘彩龙,张帆.颈前路术中钩椎关节切除减压治疗神经根型颈椎病的疗效分析[J].中国骨伤,2012,25(9):721~725 |
| 英文格式: | YUAN Jian-dong,CHEN Xin,LIU Cai-long,ZHANG Fan.Analysis of clinical effects of uncovertebral joints resection and decompression for the treatment of cervical spondylotic radiculopathy through anterior approach[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(9):721~725 |
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