颈椎前路融合术后邻近节段退变的临床观察

Clinical observation on adjacent segment degeneration after cervical fusion by anterior approach

目的探讨颈椎前路融合术后邻近节段退变的临床变化及再次手术的方法和疗效观察。方法回顾性分析2004年8月～2007年10月颈椎前路融合术患者的资料,其中11例患者出现邻近节段退变。所有患者均采取再次手术治疗,减压并将固定融合范围向邻近退变节段延伸。结果经过17.5个月(6-38个月)的随访,影像学检查所有患者的内固定位置良好,颈椎椎间融合满意,临床症状改善。结论退变好发于融合后的上位节段可易出现退行性改变,临床上症状加重或复发需鉴别原融合节段及邻近节段退变引起的主次原因,采取再次手术可获得较为满意的疗效。

Objective To investigate the clinical characteristics of adjacent segments degeneration after the first time cervical fusion by anterior approach, and to study the effects of the second surgical procedure. Methods 11 patients with adjacent segment degeneration after cervical fusion from Aug. 2004 to Oct. 2007, all of cases were studied retrospectively. These patients were treated with cervical intervetebral disc inscion, autbone grat and plate fixion after the first operation. The image study showed that both the segment up had degeneration; these cases were performed by the second operation. Results Follow up time after the second procedure was 17. 5 months （6 - 38 months） , it was satisfied for well - being fixing and fusion by X ray. Conclusion Adjacent segment degeneration usually occurs above the fusion segments. Satisfactory results may be got by the second operation for the patients of adjacent segment degeneration after the first time cervical fusion by anterior approach.