颈前路椎体次全切除联合椎间隙减压融合内固定治疗多节段颈椎病  

Anterior cervical corpectomy and fusion combined with anterior cervical discectomy and fu-sion for treatment of multilevel cervical spondylosis

作　　者：谢纪宝 郑永茂 徐秀成 郭永杰 柴充 王浩磊 XIE Ji-bao ZHENG Yong-mao XU Xiu- cheng GUO Yong-fie CHAI Chong WANG Hao-lei(Dept of Orthopaedics, General Hospital of Pingmei Shenma Group, Pingdingshan,Henan 467000, Chin)

机构地区：[1]平煤神马医疗集团总医院骨科,河南平顶山467000

出　　处：《临床骨科杂志》2017年第5期520-522,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨颈前路椎体次全切除联合椎间隙减压融合内固定术治疗多节段颈椎病的疗效。方法对26例多节段颈椎病的患者采用颈前路椎体次全切除联合椎间隙减压融合内固定术治疗,观察手术并发症情况及术后1周及6、12个月的JOA评分,并用Epstein标准评价临床症状改善情况。结果患者均获得随访,时间24个月。1例术后6 h出现颈部血肿,2例出现喉返神经牵拉伤并发症。术后1周及6、12个月时JOA评分均较术前明显提高(P<0.05)。术后12个月临床症状改善情况为:优6例,良16例,中4例。22例对手术结果满意。术后2年25例骨性融合,1例(3节段者)1个间隙不融合,但患者无临床症状。结论颈前路椎体次全切除联合椎间隙减压融合内固定术是治疗多节段颈椎病安全、有效的方法。Objective To investigate the clinical outcomes of anterior cervical corpectomy and fusion combined with anterior cervical discectomy and fusion for treatment of multilevel cervical spondylosis. Methods A total of 26 con- secutive patients with multilevel cervical spondylosis undergone anterior cervical corpectomy and fusion combined with anterior cervical discectomy and fusion were retrospectively reviewed. The operation complications and the JOA score of postoperative intervals of 1 week and 6, 12 months were recorded and assessed respectively, and the neurofunctional improvement were assessed and recorded by Epstein standard. Results All cases were regularly followed up for 24 months. One case came out neck hematomas in 6 h and 2 cases came out injury of recurrent laryngeal nerve after op- eration. The JOA scores significantly improved at 1 week and 6,12 months after operation（P 〈 0. 05）. At 12 months after operation, the neurofunetional improvement were excellent in 6 patients, good in 16 ,fair in 4. Twenty-two cases gained satisfactory results of surgery. The 25 cases got solid fusion in two years after operation. 1 intervertebral space of 1 case（3 segments） was not fused, but the patient had no clinical symptoms. Conclusions Anterior cervical cor- pectomy and fusion combined with anterior cervical discectomy and fusion is safe and effective for treatment of multi- level cervical spondylosis.

关 键 词：颈椎病 颈前路椎体切除术 内固定 脊柱融合 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]