颈椎前后路联合手术治疗颈椎管狭窄并颈椎损伤

Anterior and Posterior Contemporary Approach to Treat Cervical Spinal Stenotic Myelopathy Complicated Trauma

目的对颈椎前后路联合手术治疗颈椎管狭窄并颈椎损伤的必要性及优点进行评价。方法对14例颈椎管狭窄同时合并颈椎损伤的患者,先俯卧位行后路椎板单开门椎管成形或内固定术,再仰卧位行颈椎前路减压及植骨内固定术。结果14例患者均获随访,平均随访13个月,脊髓损伤按Frankel分级术后均有不同程度改善,损伤节段骨性融合,稳定性好,内植物无松动、脱落或断裂。结论颈椎管狭窄合并颈椎损伤同时行前后路联合手术可同时对颈脊髓前后方进行充分减压,对不稳定的颈椎节段行前方或后方的稳定手术,避免分次手术,缩短病程,减少患者痛苦。

Objective To evaluate the necessity and advantages of anterior and posterior contemporary approach to treat cervical spinal stenotic myelopathy complicated trauma. Methods Fourteen cases of cervical spinal stenotic myelopathy complicated trauma were performed the posterior operation of expansive open-door laminoplasty with internal fixation or not on supine position firstly, and then the anterior decompression, bone graft and internal fixation on prone position. Results All fourteen cases were followed-up for average 13 months. There were significant improvements of Frankel classification. The injuried segment got bony union. No instruments loosen, broken were found. Conclusion Anterior and posterior contemporary approach can decompress the cervical spinal cord thoroughly and achieve the aim of the rigid fixation, also avoid the second-period operation, shorten the length of hospitalization, release patienfs suffering.