颈椎弓根螺钉内固定对颈椎病伴颈椎后凸畸形的矫形效果  

Orthopedic effects of internal fixation of cervical pedicle screw on cervical spondylotic myelopathy with cervical kyphosis

作　　者：胡建华[1] 李佳忆[1] 杨新宇[1] 邱贵兴[1] 

机构地区：[1]中国医学科学院北京协和医院骨科,100730

出　　处：《中华医学杂志》2008年第21期1454-1457,共4页National Medical Journal of China

摘　　要：目的评价颈椎弓根螺钉内固定对颈椎病伴颈椎后凸畸形的矫形的临床疗效和安全性。方法颈椎弓根螺钉内固定治疗颈椎病伴颈椎后凸畸形17例。测量术前、术后1周及末次随访时颈椎X线中立侧位相后凸Cobb角。术后6个月及末次随访时测量颈椎X线屈伸侧位相，观察融合节段的稳定性。分析术前及术后6个月随访时JOA评分。结果平均随访时间13．8个月。术前平均颈椎后凸Cobb角为-16．1°，术后1周及末次随访时平均后凸Cobb角分别为-3．3°和-3．8°。术后6个月及末次随访时融合节段稳定。术后6个月随访时JOA评分较术前增加（5．2±1．6，P〈0．05），平均改善率为64．3％。未出现神经根、椎动脉和脊髓损伤。结论颈椎弓根螺钉内固定治疗颈椎病伴颈椎后凸畸形可以获得满意的临床疗效和安全性。Objective To evaluate the orthopedic effects of internal fixation of cervical pedicle screw on cervical spondylotic myelopathy with cervical kyphosis. Methods Seventeen patients with cervical spondylotic myelopathy with cervical kyphosis with the Cobb＇s angle 〉 10° underwent internal fixation of cervical pedicle screw. The patients were followed up for 13. 8 months. The Cobb＇ s angle of cervical kyphosis was measured before operation, one week after-operation, and upon the final follow up. The neural function and cervical spine stability were evaluated using Japanese Orthopedic Association （JOA） scoring system. Results The average preoperative Cobb＇s angle of cervical kyphosis was -16.1° before operation, was -3.3° one week after operation, and was -3.8°at the final follow-up. Follow-up 6 months after operation and at the final follow up showed that the fused segments were stable. The JOA score improved by 5.2 ± 1.6 （ P 〈 0. 05 ） with a mean JOA score improvement rate of 64. 3%. No neurovascular and instrumentation-related complications occurred. Conclusion Internal fixation of cervical pedicle screw is effective and safe in treatment of cervical spondylotic myelopathy with cervical kyphosis.

关 键 词：颈椎 脊柱后凸 内固定器 

分 类 号：R686[医药卫生—骨科学]