椎间减压并椎体次全切术治疗多节段颈椎病

Intervertebral Decompression Combined with Corpectomies in Treatment of Multilevel Cervical Spondylotic Myelopathy

目的：探讨椎间减压与椎体次全切除减压植骨融合术治疗多节段颈椎病的效果。方法：对37例累及3个节段的多节段颈椎病采用一期椎间减压加椎体次全切除减压植骨融合术。结果：经3个月-7年2个月，平均1年6个月随访，按JOA评分标准评分，结果优25例，良9例，中2例，差1例。平均改善率59．6％，优良率91．6％。3-4个月植骨融合节段全部愈合，颈椎生理曲度全部获得不同程度的恢复。结论：采用一期椎间减压加椎体次全切除减压植骨融合术结合内固定能充分、有效地解除脊髓压迫，恢复与维持颈椎椎高度和生理曲度，融合率高，并发症少。

Objective To explore the effect of intervertebral decompression combined with corpectomies in treatment of multilevel cervical spondylotic myelopathy. Methods Thirty-seven cases of multilevel cervical spondylotic myelopathy involving three segments were treated by one-staged intervertebral decompression combined with corpectomies internal fusion. Results All cases were followed for 3 months to 7 years and 2 months, averaged 1 year and 6 months. According to JOA criteria, there were excellent in 25 cases, good in 9 cases, fair in 2 cases and poor in 1 case with improvement rate of 78.9%. The excellent and good rate was 91.6%. All patients had successful fusion in 3 to 4 months. Physiological curvature change of cervical vertebrae recovered to some extent. Conclusion The method of one-staged intervertebral decompression combined with corpectomies can lead to internal fixation fully, effectively decompress the spinal cord and recover and keep the height and physiological curvature with high fusion ratio and low incidence of complication.