Tang Xiang-Sheng, Tan Ming-Sheng, Yi Ping, Yang Feng, Dong Liang
Department of Spinal Surgery,China-Japan Friendship Hospital, Beijing 100029, China.
Zhongguo Gu Shang. 2013 Jun;26(6):460-3.
To explore clinical effects of multi-segmental cervical spondylosis myelopathy through anterior approach by surgical treatment.
From September 2006 to September 2012, the data of 85 patients with multi segmental cervical spondylosis myelopathy were retrospectively analyzed. Among them, 48 cases were male, 37 cases were female, ranging the age from 34 to 86 years old (mean, 54.5 years old). Surgical procedure included anterior discectomy and fusion (19 cases), anterior secondary discectomy and fusion (45 cases) and anterior discectomy combined with anterior cervical corpectomy with fusion (21 cases). Bone fusion were evaluated by X-ray at the 3rd day after operation and following up. JOA score and improvement rate were compared.
All patients were followed up from 6 to 30 months with an average of 18 months. Decompression were done throughly during operation and good intervertebral space height and cervical curvature were obtained. X-ray showed nonunion in 3 cases, and improvement rate was 96%. JOA score after operation was higher than before operation, and had significant differences (P < 0.05). Fifty-six cases got excellent results, 16 moderate, 9 effective and 4 invalid according to JOA scores.
Surgical procedures for cervical spondylosis myelopathy should be chosen reasonably in accordance with sympotoms, signs, imaging data, so as to obtain good results in decompression, recoving intervertebral height and cervical curature, improving fusion rate.
探讨多节段脊髓型颈椎病前路手术治疗的临床效果。
回顾性分析2006年9月至2012年9月85例多节段脊髓型颈椎病患者的资料。其中男48例，女37例，年龄34～86岁（平均54.5岁）。手术方式包括前路椎间盘切除融合术（19例）、前路翻修椎间盘切除融合术（45例）和前路椎间盘切除联合颈椎椎体次全切除融合术（21例）。术后第3天及随访时通过X线评估植骨融合情况。比较日本骨科学会（JOA）评分及改善率。
所有患者随访6～30个月，平均18个月。术中减压彻底，椎间高度及颈椎曲度恢复良好。X线显示3例未融合，改善率为96%。术后JOA评分高于术前，差异有统计学意义（P<0.05）。根据JOA评分，优56例，良16例，可9例，差4例。
脊髓型颈椎病的手术方式应根据症状、体征、影像学资料合理选择，以获得良好的减压效果，恢复椎间高度及颈椎曲度，提高融合率。
