前路选择性间隙减压融合术治疗老年多节段颈椎病  

Anterior selected discectomy and fusion for multilevel cervical spondylosis in elderly patients

作　　者：黄宇峰[1] 沈彬[1] 赵卫东[1] 张振[1] 于彬[1] 吴德升[1] 赵定麟[1] 

机构地区：[1]同济大学附属东方医院脊柱外科,上海200120

出　　处：《脊柱外科杂志》2013年第1期19-22,共4页Journal of Spinal Surgery

摘　　要：目的评价前路选择性间隙减压融合术治疗65岁以上老年多节段颈椎病的临床疗效。方法回顾性分析有完整随访资料的35例手术患者,根据症状、体征及影像学结果行选择性间隙减压植骨融合内固定术。采用日本骨科学会(Japanese Orthopaedic Association,JOA)评分和Odom标准进行临床疗效评定。结果手术时间为(86.5±27.1)min,术中出血量为(95.7±42.9)mL。术前JOA评分为(8.4±2.6)分,末次随访时为(13.1±1.7)分,改善率平均为58.7%,Odom优良率为82.4%。末次随访时均获骨性融合,内固定位置良好。结论术前充分准备,准确评估,正确选择减压节段,前路选择性间隙减压融合术是治疗老年多节段颈椎病的一种安全有效的手术方式。Objective To evaluate the clinical outcomes of anterior selected discectomy and finsion fi）r maltilevel cervical spondylosis in elderly patients over 65 years. Methods A total of 35 patients who underwent surgery for multilevel eervic,al spondylosis were retrospectively reviewed. Anterior selected discectomy and fusion with Cage amt plate were ped＇ormed on file involved segments determined hy symploms, clinical examinations and radiographic documents. Japanese Orthopaedic Assot.iation（JOA） seores and Odom＇ s criteria were used to evaluate clinical outcomes. Results The operative time was （86.5 ± 27. l ） rain, and blood loss was （95.7 ±42.9） mL. The JOA score was preoperative 8.4 ±2.6 and 13.1 ± I. 7 at the final fol low-up with a mean improvement rate of 58.7%. Rate for excellent or good outcome according to Odom＇ s criteria was 82. 4%. At final follow-up, no Cage subsidence and displacement was noted, and hony fusion rate was 100%. Conclusion Anterior selected discectomy and fusion are testified safe and efficient for multilevel cervical spondylosis in elderly patients, care- fully peroperative evaluation and appropriately involved segments should be made to expect a satisfactory result.

关 键 词：颈椎 颈椎病 脊柱融合术 减压术 外科 老年人 

分 类 号：R681.531[医药卫生—骨科学]