脊髓型颈椎病前路三种术式的中期疗效比较  

Comparative study on medium-term results of anterior route three surgical methods for cervical spondylotic myelopathy

作　　者：罗鹏[1] 李锋[1] 李光辉[1] 

机构地区：[1]湖北省华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《中国矫形外科杂志》2004年第23期1780-1782,共3页Orthopedic Journal of China

摘　　要：目的比较三种颈椎前路手术治疗脊髓型颈椎病的中期疗效。方法132例脊髓型颈椎病患者,44例行环锯法颈椎前路减压植骨融合术(一组),48例行颈椎前路减压自体植骨加带锁钢板固定术(二组),40例行颈椎前路减压界面固定术(CIFC)(三组)。术后定期随访及拍摄X线片,观察疗效、椎间高度、颈椎前弯曲度和融合情况。结果经过平均30个月的随访,一组融合率为82.69%,二组融合率为92.86%,三组融合率为95.24%。终访时,一组平均椎间高度和颈椎前弯曲度较术后早期显著性降低,二组和三组则无明显性差异。一组与二、三组之间中期疗效均有显著性差异,二组与三组之间中期疗效无显著性差异。结论脊髓型颈椎病患者行前路手术时带锁钢板固定和界面固定均可使颈椎融合节段获得术后即刻稳定,提高骨性融合率,维持术后椎间高度和颈椎前弯曲度,并能维持脊髓减压效果,与环锯法颈椎前路减压植骨融合术相比具有较好的中期疗效。Objective: To evaluate the medium-term results of three kinds cervical anterior route vertebra fusion in the treatment of cervical spondylotic myelopathy(CSM).Method:In 132 cases of CSM,44 cases were used Robinson bone graft(first group),48 cases were fixed with locking plate after auto-bone graft(second group) and 40 cases were fixed with cervical interbody fusion cage (ClFC)(third group).X-ray films were taken after operation to observe the interbody height,interbody angles and fusion rate of operative segment.Result:The average period of following-up was 30 months,fusion rate of the first,sccond and third group was 82.69%,92.86%,95.24% respectively. When the following-up was over, the average of interbody height and interbody angles had significantly reduced compared with early following-up in first group, there was no significantly difference and complication of implanted material in the second and third group. There was significantly medium-term therapeutical effect difference between the first and the second and third group.but there was no significantly difference between the second and the third group.Conclusion:The immediate stability of operative segment can be obtained by using locking plate and CIFC,it can improve the fusion rate and maintain cervical interbody height and the interbody angles,have better medium-term results compared with Robinson bone graft in CSM.

关 键 词：脊髓型颈椎病 前路 椎间融合器 中期疗效 

分 类 号：R687.3[医药卫生—骨科学]