前路分节段减压植骨融合术治疗多节段颈椎病

Observation of the Clinical Effects of Segmental Anterior Cervical Decompression with Fusion on Treating Multilevel Cervical Myelopathy

目的评价前路分节段减压植骨融合术治疗多节段颈椎病的临床疗效。方法对40例连续3或4个节段病变的颈椎病患者采用分节段椎间隙减压或配合单椎体次全切除减压加植骨融合内固定术治疗，分析手术时间、术中出血量、术后3个月植骨融合率、3月时的JOA评分改善率、颈椎曲度的改变。结果患者手术时间平均为135min（80～240min），术中失血量平均为350mL（30～700mL）。术后3个月随访时JOA评分均有不同程度提高，改善率（57．18±19．28）％；3个月植骨融合率为100％，所有患者的颈椎畸形矫正后曲度明显恢复，有些恢复正常，无植骨块延期融合、内置物下沉等并发症发生。结论颈前路分节段减压植骨融合术治疗多节段颈椎病是较好的手术方式。

Objective To evaluate the clinical effects of segmental anterior cervical decompression with fusion on multilevel cervical myelopathy. Methods 40 patients of multilevel cervical myelopathy with 3 or 4 consecutive segments who were treated with anterior decompression and fusion. The parameters including operation time,blood loss, graft or implants fusion rate and improvement of JOA score 3 months postoperatively were collected. Results In our series ,the average total operative time was 135 min（80-240 min） and average blood loss was 350 mL（30-700 mL）. JOA scores in all patients were improved 3 months after operation. The rate of graft bone fusion was 100%. All patients＇ kyphotic deformity was corrected and some restored normally. No complications such as delayed graft or implants fusion and graft subsidence occurred. Conclusion Segmental anterior cervical decompression is a recommendable technique for multilevel cervical myelopathy.