颈前路椎间盘摘除椎间融合器植骨内固定术治疗交感型颈椎病  

Anterior discectomy and fusion for patients with sympathetic cervical spondylopathy

作　　者：王强[1] 罗为民[1] 汪学徽[1] 何友智[1] 罗琦山[1] 

机构地区：[1]长沙市中心医院脊柱外科,410004

出　　处：《临床外科杂志》2011年第10期698-699,共2页Journal of Clinical Surgery

摘　　要：目的观察颈前路椎间盘摘除椎间融合器植骨内固定术治疗交感型颈椎病的临床效果。方法对21例交感型颈椎病患者行颈前路椎间盘摘除椎间融合器植骨内固定术，其中1个间隙融合5例，2个间隙融合12例，3个间隙融合4例；术前及末次随访时根据JOA评分、交感神经症状改善情况及X片对患者进行临床疗效评定。结果手术均顺利完成，手术时间（134．5±24．7）min，术中出血量（92．6±65．7）ml。术后随访12～47个月，平均26个月，交感神经症状改善情况：优6例，良13例，可2例，差0例，优良率90．4％；JOA评分由术前的（10．3±1．4）分提高到末次随访时的（13．9±1．5）分，差异有统计学意义（P〈0．01）。末次随访时植骨均融合，椎间融合器及内固定位置良好。椎间融合器无沉降，颈椎前凸曲度保持良好。结论颈前路椎间盘摘除椎间融合器植骨内固定术治疗交感型颈椎病可获得较好的临床疗效。Objective To investigate the efficacy of anterior discectomy and fusion for patients with sympathetic cervical spondylopathy. Method Twenty - one patients （ 9 males and 12 females） with the mean age of 61.3 ±5.4 years（ range ,54 -73 years）treated surgically between July 2006 and December 2010 were reviewed retrospectively. Anterior cervical discectomy and fusion with cage and titanium plate were performed （ including one level in 5 cases, two levels in 12 cases, three levels in 4 cases ）. Orthopedic Association（JOA）scores and improvement of sympathetic symptoms before and after operation were compared. Bony fusion and cervical lordosis of fusion segement were evaluated according to X - ray examination. Results The average operation time was 134.5 ±24.7 min, and the mean blood loss was 92.6 ±65.7 ml. All patients were followed up for 12 - 47 months, with an average of 26 months. Improvement of sympathetic symptons was excellent in 6 cases, good in 13 cases, fair in 2 cases, and poor in 0 cases ; The excellent and good rate was 90.4%. The JOA score at final followed up （ 13.9 ±1.5 ） was significantly higher than preoperative score （ 10.3 ± 1.4 ） （ P 〈 0.01 ）. The radiological reviews showed firm bony fusion between implants and vertebrae, and no instrument displacement or subsidence happened. Conclusion Anterior diseectomy and fusion for patients with sympathetic cervical spondylopathy is reliable and effeetive

关 键 词：交感型颈椎病 椎间盘切除术 脊柱融合术 

分 类 号：R681.51[医药卫生—骨科学]