颈椎次全切植骨内固定术治疗多节段脊髓型颈椎病(附35例报告)

Subtotal Corpectomy Decompression and Interbody Fusion with Plate Fixation for Multilevel Spondylotic Myelopathy

目的:探讨颈椎椎体次全切除植骨内固定术在治疗多节段脊髓型颈椎病中对颈脊髓功能改善的疗效。方法:对35例多节段脊髓型颈椎病患者经前路椎体次全切除减压、自体髂骨植骨、钛质钢板内固定手术。病例分别摄术前,术后1周、3个月、12个月、术后最后一次随访时颈椎标准正侧位X线片,采用日本骨科协会(JOA)评分评价手术效果,对数据进行统计分析。结果:经平均27个月随访,所有病例均获骨性融合,术前与术后1周JOA评分比较差异有统计学意义(P<0.05),术后1周与术后3个月JOA评分差异有统计学意义(P<0.05),术后3个月与术后最后一次随访时JOA评分差异无统计学意义(P>0.05)。结论:应用颈椎前路椎体次全切除术治疗多节段脊髓型颈椎病在颈脊髓功能恢复方面效果满意。

Objective：To investigate the values of the neurological recovery of subtotal cervical corpectomy compression and Fusion for multilevel cervical spondylotic myelopathy（CSM）.Methods：In multilevel CSM patiants,coped with subtotal cervical corpectomy decompression and fusion with titanium plate fixation were included.Lateral cervical vertebrae X-rays and the JOA scores pre-operation,and at 1 week,3 months,12 months after operation were taken,respectiely,The data were analyzed by statistic software.Results：Fusion was reached in all cases during the mean follow-up 27 months.In JOA score,There were differences between pre-operative and 1 week post-operative（P〈0.05）.There were differences between post-operative 1 week and 3 months post-operative（P〈0.05）,there were no significant differences between 3 months post-operative and the last follow-up groups（P〉0.05）.Conclusion：For multilevel CSM,subtotal cervical corpectomy decompression and fusion with titanium plate fixation has satisfactory effect on the neurological recovery post-operatively.