一期后前路联合手术治疗多节段脊髓型颈椎病临床观察

Clinical Outcomes of the Surgical Treatment by One-stage Posterior-anterior Decompression and Stabilization

目的探讨一期后前路联合手术在治疗多节段脊髓型颈椎病中的价值。方法11例脊髓型颈椎病患者均行前路椎间盘摘除或椎体切除减压、自体髂骨植骨融合、带锁钢板内固定,后路行单开门椎板成形术。结果所有患者均获得随访,所有植骨均获得骨性愈合;疗效优8例,良2例,无效1例;并发症发生2例,其中1例C5神经根麻痹、1例手术后3个月出现相邻节段的后突、畸形。结论一期后前路颈椎管减压、内固定、植骨融合术为多节段的脊髓型颈椎病手术治疗提供了一种比较安全、可靠的方法。

Objective. To evaluate one-stage posterior-anterior decompression applied to cervical spondylotic myelopathy with multilevel stenosis. Methods： Eleven patients were operated simultaneously through the posterior laminoplasty combining the anterior discectomy or corpectomy decompression, with the autogenous iliac crest tricortical grafting, and administered the anterior locking plate fixation. Results： All patients were followed-up and showed the successful fusion. There were 8, 2 and 1 cases showed an excellent, good and failure results respectively. The perioperative complications occured in 2 cases, one CSpalsy and the other kyphosis in 3 months postoperatively. Conclusion： One-stage posterior-anterior decompress and stabilization provides a kind of safety and reliable method for surgical treatment for cervical spondylotic myelopathy with multilevel stenosis.