两种前路术式治疗单节段脊髓型颈椎病的对比研究

A Comparative Research of Single Level of Cervical Spondylotic Myelopathy Treated by Two Different Surgical Methods

目的了解两种不同的颈椎前路减压植骨融合术治疗单节段脊髓型颈椎病的疗效。方法2004年6月～2006年6月,共收治37例单节段脊髓型颈椎病,其中22例行前路减压植骨加钛板内固定术,15例行前路减压加PEEK-cage内植骨融合术。随访8～27个月,平均11个月。SPSS11.5统计软件对两术式疗效及融合率进行Chi-squaretest统计分析。结果两组植骨融合率均为100%且无供骨区并发症和椎间盘退变及椎间高度丢失。两术式疗效及融合率差异无统计学意义(P>0.05)。结论颈椎病前路手术提高疗效的关键操作是彻底减压,两种不同方式的颈椎前路减压融合术各有其优点,但是PEEK-cage内植骨融合术手术并发症少,操作相对简单,术后可获得即刻稳定,显著提高融合率。

Objective To investigate the clinical effects of two anterior cervical decompression and fusion procedures for single level of cervical spondylotic myelopathy(CSM).Methods From June 2004 to June 2006,37 cases with single level of CSM were treated in the department.Two fusion techniques were performed on 37 cases with CSM to decompress through the anterior approach.Of them,22 cases were treated with auto-ilium graft and titanium plate internal fixation and 15 cases were treated with cage filled with cancellous bone.All cases were followed for 8～31 months with an average of 11 months.Software SPSS 11.5 and Chi-square text were used to deal with the follow up data of curative effects and fusion rates.Results Both of anterior cervical fusion fine rates of the treatments were 100%,without donor-site complication or intervertebral height lost for degeneration of intervertebral disc.There were no significant differences of curative effects and fusion rates between the different procedures(P>0.05).Conclusion For the anterior cervical procedures,the key factor for advance of the curative effect is adequate decompression.The different methods of anterior cervical vertebrae decompression and fusion have different advantages,and the method of PEEK-cage for CSM has the advantages of few complications,simple manipulation,immediate stability,prevention of bone graft displacement and significant improvement of bone fusion rate.