颈椎前路融合术后邻近节段退变的翻修手术  

Revision Surgery Following Adjacent Segment Disease after Anterior Cervical Decompression and Fusion

作　　者：李杰[1] 朱悦[1] 王丰[1] 刘欣春[1] 焦鹰[1] 

机构地区：[1]中国医科大学附属第一医院骨科,沈阳110001

出　　处：《中国医科大学学报》2016年第1期73-76,共4页Journal of China Medical University

摘　　要：目的探讨颈椎邻椎病患者翻修手术方式及疗效。方法对2007年至2014年我院收治的7例颈椎前路融合术后出现邻椎病而行翻修手术治疗的患者进行回顾分析。其中颈椎前路翻修手术患者3例,后路翻修手术患者4例。采用改良JOA评分(27分法)及VAS评分进行评价。结果颈椎前路间盘切除融合术治疗患者3例,翻修术后内固定物位置良好,随访未见钢板螺钉松动,植骨块移位等;颈椎后路单开门椎管扩大成形术治疗患者4例,翻修术后无感染等并发症发生。与术前相比,颈椎前路和后路患者在术后随访结束时颈椎JOA评分均明显升高,VAS评分均明显减少。结论颈椎邻椎病翻修术式的选择应遵循兼顾减压及尽可能保留颈椎活动度的原则,翻修术后可取得满意的疗效。Objective To analyze the revision surgery and evaluate the curative effect of adjacent segment disease after anterior cervical decompression and fusion. Methods A retrospective analysis was carried out. Seven cases suffered from cervical revision surgery following adjacent segment disease after anterior cervical decompression and fusion admitted in our hospital during 2007-2014 were recruited for the study. The 3 of the 7 patients underwent anterior surgery, while the other 4 patients had posterior surgery. The curative was evaluated by the modified JOA and VAS scoring method. Results There were 3 patients underwent anterior cervical decompression and fusion, the internal fixation items locates in good position, and the postoperative follow-up did not see steel screw loosening, bone graft block shift, etc. 4 patients had posterior open-door laminoplasty surgery, and there was no intraoperative complication among all the revision patients. The JOA and VAS score of all the revision patients become better after the revision surgery. Conclusion It is necessary to consider decompression and retaining cervical activity so as to select the suitable revision surgery of adjacent segment disease. Revision surgery could achieve satisfactory result.

关 键 词：颈椎 邻椎病 翻修手术 

分 类 号：R459.9[医药卫生—治疗学]