脊髓型颈椎病前、后路手术临床疗效的对比研究  

The comparison of therapeutic effect between two different methods of cervical spine anterior and posterior in treatment of cervical spondylotie myelopathy

作　　者：王元吉[1] 李宜照[1] 陈波[1] 张圣军[1] 邹玉凤 

机构地区：[1]日照市人民医院骨科,山东省日照276826 [2]山东省蒙阴县中医医院外科

出　　处：《中国基层医药》2010年第17期2318-2319,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨脊髓型颈椎病前、后路手术的临床疗效。方法对86例脊髓型颈椎病患者分前路减压植骨内固定40例和后路单开门椎管成形术46例，比较两种手术方式对单节段、两节段、三节段、四节段压迫的改善率。结果随访20—73个月，平均43个月，两种减压术后JOA评分改善率在单节段压迫者差异有统计学意义（P〈0．05），在两节段、三节段压迫者差异无统计学意义（P〉0．05），在四节段压迫者差异有统计学意义（P〈0．05）。结论脊髓型颈椎病单节段压迫者，前路手术效果好，对于两个或三个节段压迫者，前、后路手术的疗效相同，对于四个节段的压迫，后路手术效果好。Objective To investigate the prognosis of two decompression approaches for cervical spondylotic myelopathy. Methods 86 cases were divided into two groups. 40 cases were underwent decompression by anterior decompression ,fusion and internal fixation with titanium screws and plate and 46 cases underwent posterior single opendoor laminoplasty. To investigate the prognosis of two decompression approaches for single compressive segment, two compressive segments, three compressive segments and four compressive segments. Results All cases were followed up for 20 - 73 months with an average of 43 months. The mean JOA recovery rate was significant different between single compressive segment group （ P 〈 0. 05 ）, and no significant difference between two compressive segments and three compressive segments（P 〉 0.05 ）, and significant difference between four compressive segments groups （P 〈 0. 05）. Conclusion For single compressive segment,the anterior surgery has a good surgical result,for two or three compressive segments, anterior and Posterior surgery had same effect, for the four compressive segments, posterior sur- gical effect was good.

关 键 词：脊髓型颈椎病 椎管成形术 前路手术 后路手术 手术疗效 

分 类 号：R687[医药卫生—骨科学]