颈前路减压内固定治疗脊髓型颈椎病

Treating cervical spondylotic myelopathy through anterior decompression and internal fixation

目的探讨脊髓型颈椎病颈前路的手术治疗方法及疗效分析。方法对63例脊髓型颈椎病患者行颈前路椎间盘切除减压钛网植骨或自体髂骨植入结合颈前路带锁钢板固定术。术后随访观察颈椎X线片、自我感觉、临床功能评价、神经功能恢复情况。结果63例患者全部获得随访，随访时间12～24个月（平均16个月）。手术后恢复满意，患者生活基本可自理。神经功能改善依据JOA评定标准，优29例，良18例，中10例，无效6例；JOA评分由术前（9．1±2．4）分上升至术后的（17．4±3．2）分。结论应用颈前路减压钛网植骨或自体髂骨植入颈前路带锁钢板内固定术治疗脊髓型颈椎病，具有支撑、稳定手术椎体节段和诱导成骨的优点，术后颈椎即时稳定性好，椎间融合率高。

Objective To explore the effect of surgical treatment of cervical spondylotic myelopathy through anterior decompression and internal fixation and evaluate the therapeutic effects . Methods 63 cases of cervical spoudylotic myelopathy were treated with cervical anterior decompression, reticular titanium implant or self-ilium orbital implant combined with cervical anterior internal fixation with anterior locking cervical plate. X ray , self - sensation , clicial functional evaluation , functional recovery of nerve were evaluated during follow - up postoperatively . Results All the 63 patients were followed up , the follow up time was 12 - 24 mouths（ 16 mouths average）, the postoperative treating effects were satisfactory and the patients could be basically self-cared . JOA creteria was used to evaluate the functional recovery of nerve ： excellent in 29 cases ,good in 18 cases , medium in 10 cases , ineffective in 6 cases . JOA score improved from （9.1 ± 2.4） preoperatively to （ 17.4 ± 3.2） postoperatively . Conclusions Treatment of cervical anterior decompression, reticular titanium implant or self- ilium orbital implant combined with cervical anterior internal fixation with anterior locking cervical plate has the function of supperting and stablizug the vertebra segments being operated , inducing the osteogenesis. The instant stiffness of cervical vertebra is good and intervertebral fusion rate is high.