不同手术方式对多节段连续型脊髓型颈椎病的疗效分析  

Analysis of curative effects of different operation methods for multilevel successive cervical spondylotic myelopathy

作　　者：陶春生[1] 倪斌[2] 宋展昭[1] 徐朋[1] 吴冰[1] 曲良[1] 

机构地区：[1]解放军第401医院骨一科,山东省青岛市266071 [2]上海长征医院骨科

出　　处：《中国骨与关节损伤杂志》2014年第3期209-211,共3页Chinese Journal of Bone and Joint Injury

基　　金：国家自然科学基金面上项目(21371106)

摘　　要：目的探讨不同手术方式对多节段连续型脊髓型颈椎病疗效的影响。方法选取多节段连续型脊髓型颈椎病48例,排除畸形和创伤病例。根据颈椎曲度不同,分为颈椎曲度正常组和异常组;根据所采取的手术方式不同,分为单间隙减压融合结合椎体次全切除术组、连续椎体次全切除术组以及全椎板切除术组;以术前、术后JOA评分为评估指标进行对比研究。结果在3组术前JOA评分差异无统计学意义(P>0.05)的情况下,单间隙结合椎体次全切除术组术后JOA评分与其他2组相比,差异均有统计学意义(P<0.01)。在颈椎曲度正常组中,连续椎体次全切除术组与全椎板切除术组术后JOA评分差异无统计学意义(P>0.05);颈椎曲度异常组中,连续椎体次全切除术组与全椎板切除术组术后JOA评分比较,差异有统计学意义(P<0.01)。结论不同的手术方式对多节段连续型脊髓型颈椎病的疗效不同。在没有手术禁忌的情况下,颈椎前路手术特别是单间隙减压融合结合椎体次全切除术具有更好的手术疗效。Objective To discuss the influence of curative effects of different operation methods for multilevel successive cervical spondylotic myelopathy. Methods Forty eight cases of multilevel successive cervical spondylotic myelopathy without malformation and trauma were selected. According to different cervical spine curvature, cases were divided into normal and abnormal curvature groups; according to different operation methods, eases were divided into single discectomy with corpectomy and successive corpectomy and laminectomy groups. The functional evaluation of spinal cord（established by Japan orthopaedic association JOA） before and after surgical treatment was compared. Results On the condition that JOA score of three groups before operation was not statistically significant difference（P 〉0.05）, JOA score of single discectomy with corpectomy group compared with two other groups was significantly different （P 〈0.01 ）. JOA score of successive corpectomy and laminectomy groups was not significant different （P 〉0.05） in normal curvature group. However, JOA score of successive corpectomy compared with laminectomy groups was significantly different （P 〈0.01） in abnormal curvature group. Conclusion The different operation effect of mutilevel successive cervical spondylotic myelopathy may contribute to the different operation methods. Without the contraindication, the anterior approach operation in mutilevel successive cervical spondylotic myelopathy spine, especially, single discectomy with corpectomy could result in better effect.

关 键 词：颈椎病 脊髓型 多节段 连续型 手术方式 

分 类 号：R687.3[医药卫生—骨科学]