颈前路减压及融合节段的确定方法分析

Selection of Segment of Anterior Decompression,and Reconstruction of Bone Graft

目的探讨颈前路减压及融合节段的确定。方法对手术治疗的32例颈椎病,分别摄术前及术后随访之颈椎正侧位、伸屈侧位X线片及颈椎MR检查。32例均经前路行减压、植骨融合、内固定手术治疗。以颈椎不稳节段与颈椎主要退变节段重合,并行减压内固定患者7例;对25例颈椎不稳与颈椎病节段不重合,其中仅处理颈椎病节段9例;在处理颈椎病节段同时处理颈椎不稳节段16例。以JOA"17"评分法分别对患者术前、术后随访情况予以评价,对数据行均值t检验。结果经12～36个月随访(平均25个月),所有患者均获骨性融合,平均改善率61.2%。均值t检验:术前、术后差异有统计学意义(P<0.05)。结论颈椎前路减压及融合术,合理选择颈减压及融合节段可获得满意的临床效果。

Objective To investigate the the selection of the segment of anterior decompression,and the reconstruction of bone graft.Methods Thirty-two patients with the cervical spondylosis undergoing the anterior decompression,the reconstruction of bone graft,and the fixation were included.The standard and dynamic X-ray radiographs and the cervical MR were taken preoperatively and postoperatively.Superposition between the segment of cervical spondylosis and cervical instabilities in 7 patients; No superposition and only treatment with the segment of cervical spondylosis, in 9 patients; No superposition and treatment with the cervical spondylosis and cervical instabilities at the same time in 16 patients. The preoperative and postoperative conditions were evaluated by＂JOA 17＂scoring value. The data were compared statistically with Student＇ s t - test. Results Fusions were reached in all patients during the mean followup 25 months （range 12 -36 months）. The mean improvement rate was 61.2 %. Between preoperatively and postoperatively, there were significant differences in the data with paired t - test （ P 〈 0. 05 ）. Conclusion Satisfactory clinical outcome can be achieved by proper selection of the segment of anterior decompression, the reconstruction of bone graft.