颈前路次全切钛网植骨术治疗颈椎病的疗效分析  

Clinical analysis of anterior cervical subtotal resection and titanium mesh bone grafting for cervical spondylosis

作　　者：沈锋[1] 万杰[1] 魏国文[1] 吴小海[1] SHEN Feng;WAN Jie;WEI Guowei(Department of Orthopedics,the Third Affiliated Hospital of Nanchang University,Nanchang 330008,China)

机构地区：[1]南昌大学第三附属医院骨科,南昌330008

出　　处：《江西医药》2020年第10期1369-1372,共4页Jiangxi Medical Journal

基　　金：江西省卫生厅科技计划项目,编号20143206。

摘　　要：目的观察前路颈椎椎体次全切钛网植骨钢板内固定术治疗脊髓型颈椎病的疗效。方法回顾性分析2010年5月至2013年5月,对进行了颈前路次全切除,钛网骨植骨和内固定治疗的35例颈椎病性脊髓病患者。观察其手术前后mJOA评分、VAS评分,通过测量术前、随访期间、术后的测量颈椎生理弧度Cobb角和椎间高度,并对每组测量值进行统计学分析比较。结果35例均得到随访,除外2例病人术后出现吞咽困难、1例病人出现脑脊液漏,其他患者术后临床症状较术前均有不同程度的改善,术后1年均获得植骨融合,且椎间高度均有较好的恢复和维持。结论颈椎前路椎体次全切除联合钛网植骨钢板内固定术能对于脊髓型颈椎病患者的一种安全、有效的手术方法。Objective To investigate the clinical and radiological outcomes of the anterior cervical corpectomy and fusion with anterior plating and placing titanium mesh for cervical spondylotic myelopathy.Methods A total of 35 patients(19 males,16 females,mean age 58 years old)underwent cervical corpectomy and reconstruction using titanium cage and anterior plate from May 2010 to May 2013 was retrospectively reviewed.The neurological function was evaluated by mJOA score,and the pain was evaluated by VAS score.Cervical physiological curvature,Cobb angle and intervertebral height were measured before,after and during the follow-up period.Cervical X-ray were taken at the same time points to observe cervical curve and intervertebral height.Fusion was evaluated on flexion–extension radiographs at 1 year postoperatively.Results All of 35 patients underwent follow-up at last 1 year.The clinical symptoms were improved after operation;the cervical curve and intervertebral height before and after operation were measured and compared statistically,through the cervical X-ray.and no significant difference during the follow-up.The fusion rate was 100%at 1 year.No instrument failure was observed.2 cases with postoperative dyspnea improved gradually after 6 weeks.1 case with cerebrospinal fluid leakage,which was treated by lumbar drainage,improved gradually after 1 week.Conclusion Anterior subtotal corpectomy with titanium mesh and plate fixation is a safe and effective method for the treatment of cervical spondylotic myelopathy.

关 键 词：颈椎病 前路 钛网 高度 生理弧度 

分 类 号：R687.3[医药卫生—骨科学]