前路减压植骨融合术治疗单节段颈椎病的疗效分析  

Effect of Anterior Cervical Decompression and Fusion for Single-Level Cervical Myelopathy

作　　者：何京力[1] 阮狄克[1] 侯黎升[1] 张超[1] 丁宇[1] 王德利[1] 

机构地区：[1]海军总医院骨科,北京100037

出　　处：《海军总医院学报》2006年第2期72-75,120,共5页Journal of Naval General Hospital of PLA

摘　　要：目的回顾分析前路减压植骨融合术治疗单节段颈椎病的疗效。方法37例颈椎病患者分别采用Cloward法（15例）与Smith-Robinson＋钛板内固定（22例）。采用SAS6．12软件对两组术式术前、术后1周、最后随访时日本骨科学会制定的颈椎病疗效评定标准评分、融合节段及全颈椎Cobb角、融合节段椎体前高及后高进行统计学分析。结果随访6～48个月，平均22个月。两种术式最后随访按日本骨科学会制定的颈椎病疗效评定标准评分无显著性差异，Cloward法术后融合节段椎体高度、颈椎生理前凸无变化；改良Smith-Robinson法术后融合节段椎间高度、颈椎生理前凸部分恢复，并可以维持。结论近期观察证明前路减压植骨融合术能够改善神经功能，而且改良Smith-Robinson法可改善并维持融合节段椎间高度及颈椎生理前凸。Objective To investigate the outcomes by anterior cervical decompression and fusion in the treatment of single-level cervical spondylotic myelopathy. Methods From June 1997 to June 2004, 37 cases with cervical myelopathy secondary to single-level degenerative disc herniation received anterior decompression and inter-segment bony fusion, among whom, 15 in Group A received Cloward decompression and 22 in Group B received modified Smith-Robinson decompression. Average follow-up was 22 months（6 to 48 months）. Neurologic result（JOA） and radiologic results（At, A2-7, H, and Hp）were examined to compare their outcome. SAS 6. 12 Software was introduced for statistical analysis. Results At the final follow-up time, JOA scores were improved significantly in both groups with no statistical difference between them. Kyphotic deformity in group A was not corrected, while that in group B was corrected and maintained significantly as confirmed by Af, A2-7 Ha and Hp resuits. Conclusion Intermediate follow-up showed anterior cervical decompression and fusion could improve neurological function significantly in single level cervical myelopathy, while modified Smith-Robinson decompression could further correct cervical kyphotic deformity and maintain cervical lordosis.

关 键 词：Cloward法 Smith-Robinson法 颈椎病 单节段 神经功能 颈前路钛板 

分 类 号：R681.53[医药卫生—骨科学]