颈椎病外科治疗选择及远期疗效评价  

Long-term Evaluation and Choice of Surgical Treatment for Cervical Spondylosis

作　　者：贾连顺[1] 袁文[1] 倪斌[1] 陈雄生[1] 陈德玉[1] 沈强[1] 刘祖德[1] 叶晓健[1] 肖建如[1] 谭军[1] 徐印坎[1] 赵定麟[1] 侯铁胜[1] 周维江[1] 戴力扬[1] 吴德升[1] 朱海波[1] 刘洪奎[1] 张文明[1] 张文林[1] 

机构地区：[1]第二军医大学长征医院骨科,上海200003

出　　处：《中国矫形外科杂志》2002年第13期1260-1263,共4页Orthopedic Journal of China

摘　　要：目的 :研究脊髓型颈椎病经手术治疗的远期疗效及影响疗效的因素。方法 :报告 4585例脊髓型颈椎病 ,对发病因素、病程及影像学表现进行分析。全部实施颈前路减压及自体髂骨移植融合术 ,其中 335例于术后 6个月～ 2年再次手术。术后 985例随访 5年 7个月～ 1 7年 ,平均 7年 7个月。结果 :功能评价 ,优 476例 (48.32 % )、良 335例 (34 .0 1 % )、可 94例 (9.54 % )及差 80例 (8.1 3 % )。手术疗效与病变严重程度、病程长短、减压程度和颈椎稳定性相关 ,病程在 6个月内的患者疗效优于 1年以上者 (P <0 .0 1 )。结论 :脊髓型颈椎病前路手术减压远期效果是肯定的 ;手术时机。Objective:To observe the long-term outcome of a nterior decompression for cervical spondylotic myelopathy(CSM) and factors affec ting the outcome. Methods: Nine hundred and eighty-five cases of CSM were revie wed, and their pathogenesis, history and imaging characterization were analyzed. All were treated with anterior cervical decompression and auto iliac bone graft fusion. Thirty-five cases had revision surgery 6 months to 2 years after initi al o perations. Results: Function evaluation revealed excellent in 476 cases (48.32%) , good in 335 cases (34.01%),fair in 94 cases (15.04%), and poor in 80 cases (8. 13%). Forty-five cases were between 31 to 36 points. It was found that the dura tion of illness played an important role in the final outcome. Those with histor y of illness of less than 6 months had better results than that of more than 1 y ear ( P <0.01). Conclusion: The long-term results of surgical treatment for CSM is definite. Significant factors affecting the outcome include timing of ope ration, degree of pathology and technique of surgery.

关 键 词：颈椎病 外科治疗 远期疗效评价 脊髓压迫 

分 类 号：R681.55[医药卫生—骨科学]