应用显微外科技术治疗脊髓型颈椎病疗效分析  

An efficacy evaluation of cervical spondylosis myelopathy treated by anterior approach microsurgery

作　　者：林欣[1] 宋磊[1] 李家谋[1] 邢汝鹏[1] 王冰[1] 石永常[1] 

机构地区：[1]首都医科大学北京天坛医院骨科,北京市100050

出　　处：《中国脊柱脊髓杂志》2006年第7期505-507,共3页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨应用显微外科技术治疗脊髓型颈椎病的方法及疗效。方法:2003年1月￣2004年10月对39例脊髓型颈椎病患者经颈前入路应用显微外科技术切除椎间盘、突出的髓核及骨赘,全部操作均在显微镜(10×)放大监视下应用高速磨钻、显微器械、1mm枪式椎板咬骨钳及微型刮匙配合进行。充分减压后作自体髂骨移植及钛板固定。结果:术中失血量平均每节段为80ml,术后咽喉部牵拉反应较轻,无并发症,33例患者术后症状即刻改善,2例术后3个月开始改善,4例术后6个月症状改善。无神经症状加重病例。经12～24个月随访,JOA评分由术前平均9.5分增加至13.4分,平均改善率为75.6%,影像学证实减压充分,椎体间植骨均愈合良好。结论:经颈前路应用显微外科技术治疗脊髓型颈椎病可明显提高组织分辨能力,操作精细,手术创伤小,提高了手术的安全性,疗效确切。Objectlve：To analyze the clinical results of using microsurgery for the treatment of cervical spondylosis myelopathy （CSM）.Method：From January 2003 to October 2004,thirty-nine patients with CSM were treated by microsurgery.The operating methods were to remove osteophytes,cervical degenerated disc and ossificated posterior longitudinal ligament by using operating microscope.All patients were also treated by bone graft with titanium plate fixation.Result：Averase blood loss was 80ml for each cervical segment.Tractive reaction of the throat was moderate.No complication was observed.All patients were followed up more than 12 months,33 patients＇ symptoms were improved immediately after the operation,6 patients were improved in 6 months,no patient became more serious than before.The effective rate was 75.6% according to JOA 17 score. Decompression of spine cord was complete,all of bone grafts were healed very well.Conclusion：During anterior approache microsurgery of cervical spondylosis myelopathy,the operater can get a better ability to differentiate tissues by using microscope, the operation can be performed more accurately,safely and less invasively.A better effect can be achieved.

关 键 词：脊髓型颈椎病 显微外科 植骨 内固定 手术治疗 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]