颈前路经椎间隙减压加单椎体次全切除术治疗多节段颈椎病的疗效分析  

Anterior One-Level Corpectomy Plus Adjacent-Level Discectomy on Multilevel Cervical Spondylosis

作　　者：陈为民[1] 章筛林[2] 石志才[3] 

机构地区：[1]江苏省姜堰市人民医院骨科,江苏姜堰225500 [2]苏州大学附属第一医院骨科,江苏苏州215006 [3]第二军医大学附属长海医院骨科,上海200433

出　　处：《中国临床医学》2012年第6期648-650,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:评价颈前路经椎间隙减压加单椎体次全切除术治疗多节段颈椎病的临床疗效。方法:2006年12月―2009年12月收治相邻三节段颈椎病患者31例,其中采用颈前路经椎间隙减压加单椎体次全切除植骨融合治疗19例(A组);采用两椎体次全切除植骨融合治疗12例(B组)。比较两组患者的手术时间、术中出血量、日本整形外科学会(Japanese OrthopedicAssociation,JOA)评分的改善率、植骨融合情况。结果:所有患者均得到随访,随访12～30个月,平均20个月。A组手术时间、术中出血量评估都显著优于B组(P<0.05);术后3个月植骨融合率A组为100%,B组为91.7%,差异无统计学意义(P>0.05),术后6个月两组植骨融合率均为100%;两组JOA评分均有改善,术后6个月和末次随访时的JOA评分改善率在两组间的差异均无统计学意义(P>0.05)。结论:颈前路经椎间隙减压加单椎体次全切除术治疗多节段颈椎病较两椎体次全切除更具优势。Objective：To study the clinical effects of anterior one-level corpectomy plus adjacent-level discectomy on multilevel cervical spondylosis. Methods： From December 2006 to December 2009, 31 patients with multilevel cervical spondylosis of 3 consecutive segments underwent anterior one-level corpectomy plus adjacent-level discectomy and fusion （group A） or contigu- ous twoqevel corpectomy and fusion （group B）. Operative time, blood loss, improvement of post-operative Japanese Orthope- dic Association（JOA） score and graft fusion rate were compared between the two groups. Results： All the patients were fol- lowed up for 12 to 30 months （average 20 months） . The mean operative time and blood loss of group A were statistically less than those of group B （P〈0.05）. At 3 months postoperatively Graft fusion rate of group A（100%） was higher than group B （91.7%）, but the difference was not statistically significant （P〉0.05）. At 6 months postoperatively Graft fusion rates of both groups were 100%. JOA score of all cases in both groups were improved at 6 months postoperatively, but the mean JOA improvement rate was not significantly different between the two groups（P〉0.05）. Conclusions： Anterior one-level corpecto- my plus adjacent-level discectomy is an effective method for treating multilevel cervical spondylosis and is better than contiguous two-level corpectomy.

关 键 词：颈椎病 外科减压术 椎体切除术 脊柱融合术 植骨 

分 类 号：R681.55[医药卫生—骨科学]