颈椎后路手术治疗脊髓型颈椎病的应用进展

Application of posterior cervical surgery in treatment of cervical spondylotic myelopathy

颈椎后路手术是治疗脊髓型颈椎病的常用手术方法,主要包括椎板切除术和椎管扩大成形术。后路手术常用于累及3个或3个以上节段的患者,是改善患者脊髓及神经功能的有效方法。传统手术方式用时短,出血少,是可靠的治疗方案,但并发症较多,如轴性疼痛、颈椎后凸等。鉴于此,许多学者设计了很多改良术式,力求彻底减压,持久扩大椎管,最大程度改善患者症状,恢复脊髓功能。因此,目前对于脊髓型颈椎病手术方式的选择仍存在争议。本研究对常用的颈椎后路手术方式的手术方法及临床疗效予以综述,以期为骨科医师治疗脊髓型颈椎病时选择手术方式提供重要参考。

Posterior cervical surgery is a common surgical method for the treatment of cervical spondylotic myelopathy,mainly including laminectomy and laminoplasty.Posterior surgery is often used in patients with involvement of three or more segments,which is an effective method to improve the spinal cord and nerve function of patients.The traditional operation is a reliable treatment with short time and less bleeding,but there are many complications such as axial pain,cervical kyphosis and so on.In view of this,many scholars have designed many improved surgical methods to strive for complete decompression,lasting expansion of spinal canal,maximum improvement of patients’symptoms and recovery of spinal cord function.Therefore,the choice of surgical methods for cervical spondylotic myelopathy is still controversial.In this study the surgical methods and clinical efficacy of common posterior cervical surgery were reviewed,in order to provide an important reference for orthopedics doctors in the choice of surgical methods in the treatment of cervical spondylotic myelopathy.