颈前路减压植骨融合钢板内固定术治疗脊髓型颈椎病

Anterior cervical spine decompression and interbody fusion with autografting and cervical spine locking plate fixation in treatment of cervical spondylotic myelopathy

目的探讨颈前路减压自体髂骨植骨融合钢板内固定术在治疗脊髓型颈椎病中的应用价值。方法75例脊髓型颈椎病患者，病变累及1个节段23例，2个节段46例，3个节段6例。经颈前路减压，单间隙为开窗式，余为开槽式，加自体髂骨植骨，加带锁钢板内固定。结果平均随访12个月，植骨于术后4～5月完全骨性融合。术后恢复之椎间高度未发生丢失现象，颈椎生理曲度维持良好。无脊髓、血管损伤，无钢板、螺钉折断、滑脱等并发症，但有4例术后长期存在吞咽时异物感，有1例进食时有明显梗阻感。JOA评分由平均术前8．1分上升至术后14．1分。手术优良率为83．3％。结论颈前路减压植骨融合钢板内固定术治疗脊髓型颈椎病疗效可靠。

Objective： To observe the effects of anterior eervical spine decompression and interbody fusion with autologous iliac bone grafting and cervical spine locking plate fixation in treatment of cervical spondylotie myelopathy （CSM）. Methods The mentioned operatire methods were earried out in 75 patients with CSM. Of them,single intervertebral space involved in 23 cases,two involved in 46 cases,and three involved in 6 cases. Results The average follow-up period were 12 months. Solid fusion was obtained within 4 to 5 months postoperatively. The height of intervertebral spaces corrected by surgery were maintained and the physiological curve of cervical spine kept well. There were no spinal cord or vertebral artery injuries,no hardware failm＇es and no spondylolysis. Four patients had complained about long-time foreign body sensation and another one patient had had obstructive dysphagia. The JOA score increased from 8.1 points preoperatively to 14.1 points postoperatively. Total rate of the excellent and good were 83.3%. Conclusion Cervical spondylotic myelopathy can be effectively treated by anterior cervical spine decompression and interbody fusion with autografting and cervical spine locking plate fixation. The therapeutic effect may be influenced by different kinds of plate.