脊髓型颈椎病手术方式的选择  

Choice of surgical approach for cervical spondylomyelopathy

作　　者：李晓光[1] 张凯宁[1] 任延军[1] 吴莹光[1] 卢美源[1] 

机构地区：[1]山东省千佛山医院骨科,济南250014

出　　处：《中国矫形外科杂志》2004年第19期1456-1458,共3页Orthopedic Journal of China

摘　　要：目的 :探讨对脊髓型颈椎病前、后路两种手术方式的选择标准。方法 :对 12 0例前路手术及 110例后路手术的术后日本骨科学会评分标准的改善率 (JOA改善率 )、颈椎管扩大率、颈椎生理前弯度、相邻椎间的稳定性及颈椎屈伸活动度等进行比较。结果 :(1)病变小于或等于两个间隙的病例 ,两种术式术后的JOA改善率无明显差异 ,对颈椎生理前弯度及屈伸活动度的影响前路手术优于后路手术。 (2 )病变等于或大于三个间隙的病例 ,JOA改善率后路手术大于前路手术 ,对颈椎生理前弯度的影响两者无明显差异 ,对屈伸活动度的影响后路手术优于前路手术。结论 :(1)病变小于或等于两个间隙时 ,应选择前路手术。 (2 )病变等于或大于三个间隙时应选择后路手术。 (3 )Objective:To explore the standard for choice of surgical approach in cervical spondylomyelopathy(CSM) patients Method:All patients with CSM were devided into two groups according to the surgical approach:anterior approach (120 cases) group and posterior approach (110 cases) The ameliorate rate of JOA score,cervical canal expansion rate,cervical curvature,stability of adjacent segments and the range of motion in flexion extension movement were compared between the two groups Result:(1)In patients with 2 or less segments involved,no difference was found in the ameliorate rate of JOA scores But anterior approach showed superiority in aspects of cervical curvature and range of motion than posterior was (2) In patients with 3 or more segments involved,ameliorate rate in JOA scores of anterior group was higher than that of posterior approach group But no difference was found in the effect of cervical curvature The posterior approach affected the range of motion much greater than anterior approach Conclusion:(1)In patients with 2 or less segments involved,anterior approach is preferred (2)In patients with 3 or more segments involved,posterior approach is preferred (3)In cases with developmental cervical canal steosis,posterior approach should be selected

关 键 词：脊髓型颈椎病 手术方式 研究 

分 类 号：R687[医药卫生—骨科学]