颈椎间管切开减压术的应用解剖研究与临床应用

Applied anatomic study and clinical application of facetectomy

目的：观察颈后路椎间管切开减压治疗神经根型颈椎病的疗效，确定术中神经根的减压范围。方法：测量１７具成人颈椎标本的椎间管长度及内径，并摹拟手术。采用颈椎间管切开减压治疗症状严重的神经根型颈椎病患者２７例，３２侧，随访１０个月～３年，按Ｏｄｏｍ标准评定疗效。结果：颈椎间管长度平均为５７４ｍｍ，上下径平均为９０１ｍｍ，前后径平均为６１３ｍｍ。临床２７例患者，优１５例，良９例、改进３例，优良率８８％。结论：非手术疗法久治无效；后外侧型颈椎间盘脱出有明显单根神经功能障碍者，适合于颈椎间管切开减压术，手术减压范围以切除关节突关节内侧６ｍｍ为宜。

Objective: To observe the effect of facetectomy and determine the decompression range of nerve root. Methods: The intervertebral canal was measured,and the gradual facetectomy was simulated on 17 adult cervical speciman.27 cases(32 sides) of cervical spondylosis of the nerve root type were treated with facetectomy.The followup study was carried out for 10 months to 3.3 years.The result was evaluated with the criterion of Odom. Results: The cervical intervertebal canal was 5.74 mm in length,9.01 mm in superoinferior diameter,and 6.18 mm in anteroposterior diameter.There were 15 excellent cases,9 good and 3 improved.The rate of superiority was 88%. Conclusion: Facetectomy was preferable to the cases of cervical disc herniation of the posterolated type with obvious defunction of the single never root and failing in nonoperative treatment for cervical spondylosis of the nerve root type.The resection of 6mm from the inside to outside was the best range.