前路分节段减压植骨融合术治疗多节段颈椎病的疗效分析

Segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy:analysis of the clinical effects

目的:评价前路分节段减压植骨融合术治疗多节段颈椎病的临床疗效。方法:对25例连续三节段病变的颈椎病患者采用分节段单间隙减压+单椎体次全切除植骨融合内固定术治疗,分析手术时间、术中出血量、住院时间及住院费用、术后3个月植骨融合率、JOA评分改善率,并与同期由同一组医师采用两椎体次全切除长节段植骨融合内固定术的11例患者比较。结果:两组患者术后3个月随访时JOA评分均有不同程度提高,改善率无明显差异;分节段减压手术组平均手术时间、术中平均出血量、平均住院时间均低于长节段减压组,两者在统计学上有显著性差异;分节段减压手术组术后3个月植骨融合率为100%,高于长节段减压组(91%),且无植骨块延期融合、内置物下沉等并发症发生,但两组间无统计学差异。结论:颈前路分节段减压植骨融合术治疗多节段颈椎病是较好的手术方式,具有更多优点。

Objective：To evaluate the clinical effects of segmental anterior cervical decompression with fusion on multilevel cervical myelopathy.Method：36 patients of multilevel cervical myelopathy with 3 consecutive segments who were treated with anterior decompression and fusion were divided into two groups,which were three level discectomy,single corpectomy and discectomy,and a two-level corpectomy.The parameters including operation time,blood loss,hospital stay,and patient＇s costs,graft or implants fusion rate and improvement of JOA score 3 months postoperatively were collected.The data was compared statistically with Student＇s T-test. Result：JOA score in all groups were improved 3 months after operation,but there were no significant differences among three groups.Segmental decompression with fusion group had lower blood loss,shorter operation time and hospital stay than two-level corpectomy with fusion group,and there were significant differences among them.Segmental decompression group had higher fusion rate（100%） than two-level corpectomy with fusion group（91%） 3 months postoperatively,and no complications such as delayed graft or implants fusion and graft subsidence,but there were no significant differences among them.Conclusion：Segmental anterior cervical decompression is a recommendable technique for multilevel cervical myelopathy.