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[不植骨椎体次全切除术治疗脊髓型颈椎病的评估与治疗]

[Evaluation and treatment of cervical spondylotic myelopathy by subtotal corporectomy without grafting].

作者信息

Born J D

出版信息

Bull Mem Acad R Med Belg. 2000;155(3-4):171-9; discussion 179-82.

Abstract

These experimental and clinical studies were performed to evaluate the efficiency of a new surgical procedure in the treatment of spondylotic myelopathy, the subtotal corpectomy without fusion. In a first step, the biomechanic analysis of eleven human cadaveric cervical spines, before and after corpectomy without grafting, demonstrated that this procedure does not reduce significantly the cervical stiffness. In a second step, we prospectively evaluate 77 patients operated between 1990 and 1998. The average follow-up period was 53 months (range: 10 to 111 mo). We conclude that this procedure is a safe and efficient treatment for cervical spondylotic myelopathy. No fusion is required regardless of the number of levels, providing there is no preoperative instability. We showed that clinical myelopathy severity and age are significant predictors of the outcome.

摘要

进行这些实验和临床研究是为了评估一种治疗脊髓型颈椎病的新手术方法——不融合椎体次全切除术的疗效。第一步,对11具人尸体颈椎在未植骨椎体次全切除术前和术后进行生物力学分析,结果表明该手术并未显著降低颈椎刚度。第二步,我们前瞻性地评估了1990年至1998年间接受手术的77例患者。平均随访期为53个月(范围:10至111个月)。我们得出结论,该手术是治疗脊髓型颈椎病的一种安全有效的方法。无论手术节段数量多少,只要术前无不稳定情况,就无需融合。我们发现临床脊髓病严重程度和年龄是预后的重要预测因素。

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