颈椎病前路减压植骨内固定术的临床应用

Investigations on anterior incision decompression and interbody fusion with plate fixation in the treatment of cervical spondylosis

目的:探讨颈前路颈椎间盘切除或椎间盘切除+自体髂骨植骨+钢板内固定治疗方法选择及早期临床效果。方法:采用前方颈椎间盘切除自体植骨融合钢板内固定手术56例。结果:随访3个月至4年。优29例,良11例,可11例,无效5例。无复发病例。优良率71%,有效率92%。结论:椎间盘切除及髂骨植入融合带锁钢板固定术有助于早期功能锻炼,减少外固定时间,有助于防止植骨块塌陷、保持椎间高度及颈椎的生理前曲,这将有利于提高手术远期结果。

Objective To observe the effects of anterior incision decompression and interbody fusion with anterior cervical self locking plate (ACLP) fixation on cervical spondylosis. Methods Fifty six patients suffered from cervical spondylosis were treated surgically with anterior decompression and autogeneic graft fusion with ACLP fixation, who were followed up 3 months to 6 years. The clinical results were evaluated with the JOA score, the pathogenesis, history as well as characteristics on imaging (CT and/or MRI), X ray films. Results Recovery or improvement of spinal injury was found in patients after operation. Of which 29 cases was excellent, 11 good, 11 fair and 5 poor. The percentages of the excellent and good and the efficiency was 71%and 92%, especially. No complications such as paraplegia, blood vessel injures, infection and death occurred. Conclusions Use of ACLP fixation for anterior incision decompression and interbody fusion can be more effective to prevent graft collapse, to shorten the fixation time, to keep the height of intraspinal space and physiological curve of cervical verbrate, contributing to the recovery of spinal function.