前路选择性椎体切除结合单间隙减压植骨融合术治疗三节段脊髓型颈椎病的临床疗效  

Clinical outcomes of selective anterior cervical corpectomy combined with segmental disectomy and fusion for treating three-level cervical myelopathy

作　　者：曹涌[1] 张烽[1] 陈向东[1] 姜星杰[1] 

机构地区：[1]南通大学附属医院脊柱外科,226001

出　　处：《江苏医药》2011年第14期1672-1674,共3页Jiangsu Medical Journal

摘　　要：目的分析颈前路选择性椎体次全切除＋单间隙减压植骨融合术治疗三节段脊髓型颈椎病的临床疗效。方法 13例脊髓型颈椎病患者行颈前路选择性椎体次全切除＋单间隙减压、自体髂骨植骨、钢板内固定术。分析术前及随访时的日本骨科协会（JOA）评分,记录术后Odom分级。测量术前、术后1周及末次随访时颈椎侧位X线片,观察术后颈椎植骨融合率、颈椎曲度（Cobb角）维持、症状及功能改善率。结果 13例患者随访12~39个月,术后3个月JOA评分为（14.6±1.0）分,明显高于术前的（11.1±1.0）分（P〈0.01）。术后Odom分级：优8例,良3例,一般2例,植骨融合率100%。术前Cobb角为3.7度,术后1周为10.7度,末次随访为10.4度。结论颈前路选择性椎体次全切除＋单间隙减压、自体髂骨植骨、钢板内固定术在充分减压的同时可以获得较高的植骨融合率。Objective To evaluate the clinical outcomes of selective anterior cervical corpectomy combined with segmental disectomy and fusion for treating three-level cervical myelopathy.MethodsThirtee patients of multilevel cervical myelopathy with 3 consecutive segments were treated with anterior cervical corpectomy combined with segmental disectomy and fusion.Study parameters included JOA score and grading the Odom criteria.The sagittal segmental alignment of fusion levels was measured using the Cobb method before and after surgery.Graft fusion rate was observed during final follow up.Results The patients were followed up for 12 to 39 months.The JOA score of 13 patients was higher three months after surgery than that before[（14.6±1.0） points vs.（11.1±1.0） points]（P0.01）.Surgical results of Odom criteria were excellent in 8 cases,good in 3 cases,fair in 2 cases.Graft fusion rate was 100%.Radiograph analysis indicated that the Cobb angle of mean segmental lordosis was 3.7 degrees before,10.7 degrees one week later and 10.4 degrees during the final follow up.Conclusion Selective anterior cervical corpectomy combined with segmental disectomy and fusion results in high fusion rates with sufficient decompression in the treatment of three-level cervical myelopathy.

关 键 词：多节段颈椎病 椎间盘切除术 椎体次全切除术 脊柱融合术 

分 类 号：R681[医药卫生—骨科学]