前后路联合颈椎管扩大成形术治疗严重脊髓型颈椎病  

Expansive Cervical Laminoplasty by Anterior and Posterior Cervical Decompression in the Treatment of Severe Cervical Spondylosis Myelopathy

作　　者：孙继飞[1] 何强[1] 刘振利[1] 陈庆胜[1] 

机构地区：[1]中国人民解放军第251医院骨二科,张家口075000

出　　处：《中国现代手术学杂志》2011年第5期366-368,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的评价前后路联合颈椎管扩大成形术治疗脊髓型颈椎病伴发育性颈椎管狭窄的临床效果。方法我科于2007年3月～2010年12月间应用该手术方式治疗22例严重脊髓型颈椎病患者。其中,发育性颈椎管狭窄合并颈椎间盘退行变突出17例,发育性颈椎管狭窄发育合并后纵韧带钙化5例。手术前后通过神经功能JOA评分、颈部轴性症状评估和颈椎动态侧位片、颈椎MRI进行临床疗效比较。结果 22例患者均获随访,平均随访时间24(3～36)个月。根据JOA评分,术后优良率为81.8%(18/22),颈部轴性症状减轻,X线检查未见颈椎不稳,MRI示颈髓压迫解除。结论前后路联合颈椎管扩大成形术治疗脊髓型颈椎病合并发育性颈椎管狭窄是一种疗效好且效果稳定的手术方法。Objective To evaluate the clinical results of expansive cervical laminoplasty by anterior and posterior cervical decompression in the treatment of cervical spondylosis myelopathy with developmental cervical stenosis.Methods 22 patients of severe cervical spondylosis myelopathy treated with expansive cervical laminoplasty by anterior and posterior cervical decompression from March 2007 to December 2010.There were 14 males and 8 females aged from 48 to 72 years old who suffered from the developmental cervical stenosis（DCS）with cervical intervertebral dics protrusion in 17 cases,with the ossification of posterior longitudinal ligament（OPLL） in 5 cases.The JOA score of the neural function,cervical axial symptoms,and pre-and postsurgery dynamic cervical spine lateral x-ray films and cervical vertebra MRI were evaluated.Results All cases had been followed up for 3 to 36 months.The fine rate of the JOA score was 81.8%（18/22）.Cervical axial symptoms were improved.Instability of the cervical spine was not found and decompression was confirmed on MRI.Conclusion It shows good and stable efficacy of the expansive cervical laminoplasty by anterior and posterior cervical decompression in the treatment of cervical spondylosis myelopathy with developmental cervical stenosis.

关 键 词：椎管成形术 减压术 外科 颈椎病 

分 类 号：R687.3[医药卫生—骨科学]