颈椎过伸伤伴颈椎管狭窄症的早期后路手术治疗  

Treatment of hyperexsion injury with severe cervical spondylotic myelopathy by early posterior laminectomy and fusion

作　　者：谭俊铭[1] 王朝阳[1] 陈德纯[1] 邢顺民[1] 申练兵[1] 苏加向[1] 廖腾[1] 时国华[1] 何翔[1] 王金鑫[1] 来津[1] 

机构地区：[1]解放军第98医院全军创伤修复重建中心暨骨六科,浙江湖州313000

出　　处：《颈腰痛杂志》2012年第6期425-428,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：南京军区医学科研重点课题资助(编号2007-14);全军12-5医学科研课题资助项目(编号:CWS11J260)

摘　　要：目的回顾分析了早期颈后路切除减压融合治疗18例颈椎过伸伤伴颈椎管狭窄患者。方法术前常规X线、CT和MRI检查,其中11例患者存在异常T2加权MRI信号,手术前后分别行Nurick和Niu系统评估。随访6个月-5.5年,平均2.4年。结果平均Niu评分由术前6.22（5-7）提高到术后4.72（3-7）,15例患者（83.3%）的最后随访示Nurick评分至少提高Ⅰ级,3例无明显改善和恶化。术后6例患者仍存在T2加权MRI信号异常。结论颈椎过伸伤伴颈椎管狭窄症患者行早期后路椎板切除减压融合可取得较好的临床效果,术后疗效改善明显,并发症发生率较低。Objective To retrospectively evaluate the therapeutic effect of 18 patients with hyperexsion injury and severe multilevel cervical spondylotie myelopathy treated by early posterior laminectomy and fusion. Methods All patients had preoperative radiographs,computed tomography and magnetic resonance imaging,and noted 11 patients had abnormal T2-weighted MRI signal. Neurologie function and clinical assessment of myelopathy were graded preoperatively and postoperatively by the grading system of Nurick and Niu respectively. The mean follow-up period were 26 months（from 6 months to 5.5 years）. Results Mean Niu score improved from 6.22（range 5-7） to 4.72 （range 3-7） postoperatively. Fifteen patients （83.3%） had improvement in Nurick grade of at least one level,and three showed no improvement. There were 6 cases had residual abnormal T2- weighted MRI signal postoperatively. Conclusion Good clinical effectiveness are obtained from early laminectomy and fusion in hyperexsion injury with severe multilevel cervical myelopathy and obviously improvement of myelopathy are observed, with low complication rates were.

关 键 词：多节段脊髓型颈椎病 椎板切除术 融合 内固定 

分 类 号：R681.55[医药卫生—骨科学]