| 颈前路分节段减压植骨融合术治疗多节段颈椎病 |
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投稿时间：2013-12-22
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| 作者 | Author | 单位 | Address | E-Mail |
| 董亮 |
DONG Liang |
中日友好医院脊柱外科, 北京 100029
北京协和医学院研究生院, 北京 100005 |
Department of Spinal Surgery, China-Japan Friendship Hospital, Ministry of Health, Beijing 100029, China |
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| 谭明生 |
TAN Ming-sheng |
中日友好医院脊柱外科, 北京 100029
北京协和医学院研究生院, 北京 100005 |
Department of Spinal Surgery, China-Japan Friendship Hospital, Ministry of Health, Beijing 100029, China |
zrtanms@sina.com |
| 移平 |
YI Ping |
北京协和医学院研究生院, 北京 100005 |
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| 杨峰 |
YANG Feng |
北京协和医学院研究生院, 北京 100005 |
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| 唐向盛 |
TANG Xiang-sheng |
北京协和医学院研究生院, 北京 100005 |
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| 期刊信息：《中国骨伤》2014年，第27卷，第12期，第995-999页 |
| DOI：10.3969/j.issn.1003-0034.2014.12.005 |
| 基金项目: |
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中文摘要:
目的: 评价颈椎前路分节段减压植骨融合术治疗多节段颈椎病的有效性和安全性.
方法: 自2006年6月至2013年6月,采用颈前路保留中部椎体、分节段减压、植骨融合、钛板螺钉内固定术治疗连续4个节段病变的颈椎病患者24例,其中男15例,女9例;年龄47～75岁,平均57.9岁.分别于术前、术后1周和末次随访时行标准正侧位X片观察融合、植入物移位、相邻节段病变、融合节段Cobb角的变化.采用JOA评分对神经功能恢复情况进行评价.
结果: 手术均顺利完成,术后2例患者出现声音嘶哑,对症处理后逐步好转.19例患者获得随访,平均随访3.9年(3.1～5.3年).随访患者平均植骨融合时间为4.5个月(3～7个月);末次随访时无螺钉松动、移位等发生;9例患者钛网不同程度下沉,其中4例下沉>3 mm;4例相邻节段退变.融合节段Cobb角由术前的(5.76±4.16)°提高到术后1周的(10.40±2.94)°(P<0.01);末次随访时下降到(8.57±2.82)°,与术前比较差异有统计学意义(P<0.01);JOA评分末次随访时(14.6±1.1)与术前(8.2±1.9)比较差异有统计学意义(P<0.01).
结论: 颈椎前路分节段减压植骨融合术治疗多节段颈椎病,具有临床可操作性,在彻底减压的同时,在恢复颈椎曲度和神经功能状态方面具有一定优势. |
| 【关键词】颈椎病 减压术,外科 植骨 融合 |
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| Segmental anterior cervical decompression with fusion for the treatment of multilevel cervical myelopathy |
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ABSTRACT
Objective: To explore effectiveness and safety of segmental anterior cervical decompression in treating multilevel cervical myelopathy.
Methods: Twenty-four patients with four levels of cervical myelopathy were treated with segmental anterior cervical decompression(reservation of middle vertebrae,bone graft and plate-screws fixation). Among patients,there were 15 males and 9 females aged from 47 to 75 (averaged 57.9) years old. Preoperative,postoperative at 1 week and the latest following -up AP and lateral X-rays were used to observe bone union,displacement of implant,adjacent segment degeneration,changes of Cobb angle of fusion segment. JOA scoring were applied for evaluate recovery of nerve function.
Results: All operations were completed successfully,2 cases ocurred hoarseness,and improved after treated symptomatically. Nineteen patients were followed up from 3.1 to 5.3 years with an average of 3.9 years. Bone union time ranged from 3 to 7 (averaged 4.5) months. No screw loosening and displacement occurred. Nine patients occurred titanium mesh subsidence in different degrees,and 4 of them subside >3 mm; four patients ocurred adjacent segment degeneration. Postoperative Cobb angle of fusion segment at 1 week (10.40±2.94)°was improved from preoperative (5.76±4.16)°,but decreased at the latest follow-up (8.57±2.82)°,and had significant meaning compared with preoperative(P<0.01). JOA score at the latest follow-up (14.6±1.1) was higher than that of before operation(8.2±1.9),and had siginificant differences(P<0.01).
Conclusion: Segmental anterior cervical decompression for the treatment of multilevel cervical myelopathy has a high clinical operability,and plays an important role in recovering cervical curvature and nerve function based on completely decompression. |
| KEY WORDS Cervical spondylosis Decompression,surgical Bone grafting Fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 董亮,谭明生,移平,杨峰,唐向盛.颈前路分节段减压植骨融合术治疗多节段颈椎病[J].中国骨伤,2014,27(12):995~999 |
| 英文格式: | DONG Liang,TAN Ming-sheng,YI Ping,YANG Feng,TANG Xiang-sheng.Segmental anterior cervical decompression with fusion for the treatment of multilevel cervical myelopathy[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(12):995~999 |
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