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多节段脊髓型颈椎病不同手术方法疗效的临床对照试验
Hits: 1853   Download times: 1255   Received:June 28, 2007    
作者Author单位UnitE-Mail
占蓓蕾 ZHAN Bei-lei 衢州市中心医院骨科,浙江衢州324000 Department of Orthopaedics,Quzhou Central Hospital,Quzhou 324000,Zhejiang,China  
叶舟 YE Zhou 衢州市中心医院骨科,浙江衢州324000 Department of Orthopaedics,Quzhou Central Hospital,Quzhou 324000,Zhejiang,China  
期刊信息:《中国骨伤》2007年20卷,第10期,第669-671页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:比较多节段椎间减压植骨融合术、椎体次全切除减压植骨融合术以及保留椎体后侧壁植骨融合术治疗多节段脊髓型颈椎病的治疗效果。

方法:对93例多节段脊髓型颈椎病分别采用多节段椎间减压植骨融合术(25例,男18例,女7例;年龄36~75岁,平均52岁);椎体次全切除减压植骨融合术(30例,男24例,女6例;年龄35~72岁,平均48.6岁);保留椎体后侧壁减压植骨融合术(38例,男27例,女11例;年龄33~76岁,平均50.6岁)治疗。术后根据JOA评分及X线表现比较3种方法的治疗结果。

结果:本组均获得随访,时间3个月~5年7个月,平均2.5年。3组患者术后3、12个月JOA评分与术前比较,差异有统计学意义(P<0.05),各组间比较差异无统计学意义(P>0.05);术后12个月改善率,A组比B、C组较术后3个月时有显著下降(P<0.05)。

结论:3种手术方法均可获得满意的效果。多节段椎间减压植骨融合术的症状改善维持时间短,且常反复发作。椎体次全切除减压植骨融合术与保留椎体后侧壁植骨融合术症状反复较少,疗效维持时间长。
[关键词]:多节段脊髓型颈椎病  前路减压  脊柱融合术  临床对照试验
 
A controlled clinical trial of different operative methods in multi-segmental cervical spondylotic myelopathy
Abstract:

Objective:To compare therapeutic efficacy of ①cervical interbody fusion and multi-segmental decompression(group A using method A) ②corpectomy and cervical interbody fusion(group B using method B) ③reserved posterior wall of vertebral body combined with resection of vertebral body,decompression and cervical interbody fusion(group C using method C),in treating multi-segmental cervical spondylotic myelopathy(CSM).

Methods:Ninety-three patients with CSM were treated with three methods.Twenty-five cases(male 18 and female 7,aged from 36 to 75 years old with the mean of 52 years)with method A.Thirty cases(male 24 and female 6,aged from 35 to 72 years old with the mean of 48.6 years)with method B.Thirty-eight cases(male 27 and female 11,aged from 33 to 76 years old with the mean of 50.6 years) with method C.The therapeutic efficacy of three groups was analyzed according to JOA score and X-ray.

Results:Patients were followedup from 3 months to 5 years and 7 months with the mean time of 2.5 years.The JOA score of three groups at 3,12 months after operation improved compared with that before operation(P<0.05).But there was no significant difference among the three groups(P>0.05).The improvement rate at 12 months after operation decreased compared with that at 3 months after operation in all groups,but group A was the most significant(P<0.05).

Conclusion:All methods can obtain satisfactory effect for multi-segmental cervical spondylotic myelopathy.The symptom often recur with method A,the symptom seldom recur with method B,C.
KEYWORDS:Multi-segmental cervical spondylotic myelopathy  Decompression through anterior approach  Spine fusion  Controlled clinical trials
 
引用本文,请按以下格式著录参考文献:
中文格式:占蓓蕾,叶舟.多节段脊髓型颈椎病不同手术方法疗效的临床对照试验[J].中国骨伤,2007,20(10):669~671
英文格式:ZHAN Bei-lei,YE Zhou.A controlled clinical trial of different operative methods in multi-segmental cervical spondylotic myelopathy[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(10):669~671
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