微创颈前路减压融合术治疗急性颈椎间盘突出症

Treatment of acute cervical disc herniation with minimally invasive cervical anterior operation.

目的探讨微创颈前路减压融合术治疗急性颈椎间盘突出症的应用价值。方法对33例急性颈椎间盘突出症患者术前进行磁共振成像（MRI）和CT检查确诊，行微创颈前路颈椎间盘髓核摘除术，同时行减压及颈椎椎体间融合器融合术。随访28例，平均随访时间22．6月，观察病人的椎体间高度、颈椎生理曲度、融合率、内植物并发症并进行功能评价。结果。28例均获得骨性愈合，术后椎体间高度和颈椎生理曲度维持满意，未发生内植物并发症。采用Odom评定，22例，良4例，一般2例，差0例，优良率92．8％。结论微创颈前路减压融合术治疗急性颈椎间盘突出症，可及早解除脊髓压迫，并使颈椎融合节段获得术后即刻稳定，提高椎体间骨性融合率和维持术后椎体间高度，并能维持脊髓减压疗效。

Objective To investigate the value of minimally invasive cervical anterior operation in the treatment of acute cervical disc herniation. Methods Thirty three patients with acute disc herniation of the cervical spine were presented. Magnetic resonance imaging （MRI） and CT was conducted in all patients. All the cases were treated with minimally invasive cervical anterior operation. Twenty eight cases were followed up, the average period of followup was 22.6 months. The bone graft fusion rate, maintenance of intervertebral height, physiology curves and the complications were observed as well as the functions were valued. Results Bone fusion was obtained in 28 cases, maintenance of intervertebral height and physiology curves were satisfactory. No complications were happened. The followup showed that excellent and good results were achieved in 92.8%. Conclusion Minimally invasive cervical anteri- or operation can relieve the compression of spinal cord earlier. The immediate stability of the operated segments can be obtained by using cervical interbody fusion cage. It can improve the fusion rate and maintain cervical interverteral height, and support the therapy of the decompression in cervical spondylotic myelopathy.