退化性颈椎病变的手术治疗

The surgical treatment of degenerative cervical disease

目的:探讨退化性颈椎病变不同手术方式的优劣。方法:回顾性分析155例退变性颈椎病经不同手术入路的治疗结果,根据术前、术后的评分变化,比较前、后入路手术效果的差异,并对并发症进行分析。155例中有136例(87.7%)行前路减压植骨术,19例行后路减压术(12.3%),28.6%的病例采用内固定。结果:平均随访4年1个月,93.7%在手术后评估中获得良好结果,症状明显改善。并发症包括神经功能恶化1例,移植骨块移位9例,螺钉松动2例,浅层伤口感染4例。结论:要想达到一个理想的治疗效果,术前病例选择是最重要因素,前路手术在退变性颈椎病的治疗中扮演重要角色。

Objective To compare the advantages of different operative methods for the treatment of degenerative cervical disease.Method The results of 155 cases with degenerative cervical disease underwent different surgical approaches were analyzed retrospectively.The advantages of different approaches were compared according to the score of pre-and post-operation,and the complication was analyzed as well.136 cases（87.7%）underwent anterior approach with bone graft,19 cases（12.3%）underwent decompression by posterior approach,and 28.6% of cases applied internal fixation.Results The average follow up period was 4 years and 1 month.93.7% of the patients had apparent neurological improvement postoperatively.The complications included severe neurological dysfunction in 1 case,displacement of graft bone in 9 cases,loose of screw in 2 cases and superficial wound infection in 4 cases.Conclusion In order to achieve an ideal outcome,the choice of cases is the most important factor.Anterior approach plays an important role in the treatment of degenerative cervical disease.