Huang Kai, Chang Bu-Qing, Yu Chao-Jiang, Gao Xiao, Jiang Yun-Chang, Feng Hu
Graduate School, Xuzhou Medical University, Xuzhou 221000, Jiangsu, China;
Zhongguo Gu Shang. 2018 Jan 25;31(1):18-22. doi: 10.3969/j.issn.1003-0034.2018.01.004.
To investigate the clinical outcomes of anterior corpectomy combined with anterior intervertebral decompression and fusion for multilevel cervical spondylotic myelopathy.
The clinical data of 28 patients with multilevel cervical spondylotic myelopathy who underwent surgery from October 2012 to June 2014 were retrospectively analyzed. There were 18 males and 10 females, aged from 45 to 77 years old with an average of (60.11±9.37) years. Three levels were involved in 27 cases, while four levels were involved in 1 case. The preoperative JOA score was 8.89±1.87; the fusion segments angles was (4.87±4.56)°; and the cervical curvature was (11.68±1.25)°. Anterior hybrid decompression and fusion were performed in 28 patients. The fusion segments angles and the cervical curvature were assessed by X-rays at 1, 12 months after operation, respectively. JOA score was used to evaluate the clinical effect.
The operative time was 163 min on average (ranged from 120 to 205 min), and intraoperative bleeding was 198 ml on average(ranged from 100 to 300 ml). Hoarseness occurred in 1 case and got recovery at 3 weeks after operation and choke cough occurred in 1 case, and got improvement at 1 week after operation. All the patients were regularly followed for 12-24 months with an average of(18.46±3.20) months. Graft bone obtained fusion at 12 months after operation and the position of internal fixation was good. The fusion segments angles, the cervical curvature and JOA scores were significantly improved at 1, 12 months after operation(<0.05). The improvement rate of JOA score was(46.46±20.26)% at 12 months after operation, 12 cases got excellent results, 14 good and 2 fair.
Anterior corpectomy combined with anterior intervertebral decompression and fusion is safe and effective and can get satisfactory effects for multilevel cervical spondylotic myelopathy.
探讨前路椎体次全切除联合前路椎间减压融合术治疗多节段脊髓型颈椎病的临床疗效。
回顾性分析2012年10月至2014年6月行手术治疗的28例多节段脊髓型颈椎病患者的临床资料。其中男18例，女10例，年龄45～77岁，平均（60.11±9.37）岁。累及3个节段27例，累及4个节段1例。术前JOA评分为8.89±1.87；融合节段角度为（4.87±4.56）°；颈椎曲度为（11.68±1.25）°。28例患者均行前路混合减压融合术。分别于术后1个月、12个月行X线检查评估融合节段角度及颈椎曲度。采用JOA评分评估临床疗效。
平均手术时间163分钟（120～205分钟），平均术中出血量198毫升（100～300毫升）。术后出现声音嘶哑1例，术后3周恢复；呛咳1例，术后1周好转。所有患者均获规律随访12～24个月，平均（18.46±3.20）个月。术后12个月植骨融合，内固定位置良好。术后1个月、12个月融合节段角度、颈椎曲度及JOA评分均较术前显著改善（<0.05）。术后12个月JOA评分改善率为（46.46±20.26）%，优12例，良14例，可2例。
前路椎体次全切除联合前路椎间减压融合术治疗多节段脊髓型颈椎病安全有效，可获得满意疗效。
