两种不同术式治疗多节段脊髓型颈椎病的比较  

Comparison of two different surgical methods for multi-level of cervical spondylotic myelopathy

作　　者：徐军[1] 田军[1] 许超蕊 郑伟卓[1] 李伟[1] 陶天遵[1] 

机构地区：[1]哈尔滨医科大学附属第二临床医院骨科,黑龙江哈尔滨150086 [2]黑龙江省立医院老年病科,黑龙江哈尔滨150036

出　　处：《临床骨科杂志》2008年第4期312-315,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨两种不同的颈椎前路减压植骨融合术治疗多节段脊髓型颈椎病的疗效。方法37例多节段脊髓型颈椎病患者中,22例行前路椎体次全切除减压钛网内植骨钛板内固定术,15例行分节段颈椎间盘切除、减压+PEEK-cage内植骨椎间融合术。对两种术式疗效及融合率进行统计分析。结果37例均获随访,时间10～31(18±4.25)个月,两组植骨均融合且无椎间盘退变及椎间高度丢失。两术式疗效及融合率比较差异无显著性(P>0.05)。结论颈前路减压植骨内固定治疗多节段脊髓型颈椎病,可取得满意效果,应根据患者病理特点,选择恰当的术式。Objective To investigate the clinical effects of two anterior cervical decompression and fusion procedures for multi-level of cervical spondylotic myelopathy（CSM）. Methods 37 patients with multi-level of CSM were treated in the department. Two fusion techniques were performed on 37 cases with CSM through the anterior approach. Of them,22 cases were treated with anterior cervical discectomies, decompression, titanium mesh cage filled with local autologous bone graft, and cervical locking plate internal fixation and 15 cases were treated with PEEK-cage filled with cancellous bone. Chi-square text was used to deal with the follow up data of curative effects and fusion rates. Results 37 patients were followed up for 10 -31 months with an average of 18 ±4. 25 months. All of the treatment of anterior cervical fusion rate was fine, without intervertebral height lost for degeneration of intervertebral disc. There were no significant difference of curative effects and fusion rates between the different procedures（ P 〉 0. 05 ）. Conelusions Most patients with multi-level-CSM can achieve satisfied prognosis by anterior approach decompressoin with bone grafting and plate fixing. The operation method should be take occording to the pathology, changes,

关 键 词：脊髓型颈椎病 多节段 内固定器 脊柱融合术 

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