手术治疗脊髓型颈椎病56例疗效观察

The curative result of cervical spondylotic myelopathy with operative treatment

目的 探讨手术治疗脊髓型颈椎病的指征、进路、技巧。方法 对 5 6例脊髓型颈椎病患者施行手术 ,其中前路减压及椎间植骨融合术 4 6例 ,后路颈椎板双开门成形术 10例。结果 经随访 2～ 8a ,平均 5 2a,前路手术优良率 82 6% ,后路椎板开门成形术优良率 90 %。结论 对脊髓型颈椎病 ,前路及后路手术各有其适应证 ,应根据脊髓腹侧或背侧受压加以决定 ,应早期诊断和尽早手术。彻底减压和良好的手术技巧是提高疗效的重要因素 ,在这方面 。

Objective The indication, approach and technique of operative treatment for cervical spondylotic myelopathy (CSM) is discussed.Methods From 1991 to 1996, operative treatment was carried on in 56 patients with CSM. 43 male and 13 female, age from 28 to 65 years, 46 cases were treated with anterior decompression and bony fusion while 10 cases with posterior double open-door laminoplasty. Results All these patients were followed-up for an average period of 5 2 years (2～8 years). The excellent and good result of anterior approach was 82 6% and that of posterior approach was 90%.Conclusion The indication of anterior operative approach is different from posterior approach according to the location of the compression. Early diagnosis and operation may give a good result. Thorough decompression and careful operative technique are important. Suggestions and experiences are introduced by the authors in this respect.