经前路椎间孔减压植骨固定治疗神经根型颈椎病

Anterior Cervical Foraminal Decompression and Fusion Fixation of Cervical Spondylotic Radiculopathy

目的探讨经前路颈椎间孔减压植骨融合内固定术治疗神经根型颈椎病的疗效。方法回顾分析我院自2005年1月至2008年12月对21例神经根型颈椎病患者采用的经前路颈椎间孔减压植骨融合内固定术治疗。采用日本骨科学会(Japanese orthopaedics association,JOA)及视觉模拟评分(visual analogous scale,VAS)评分,观察术前、术后即刻、6个月、18个月疗效。结果共治疗观察21例患者,采用JOA评分,术前评分(8.50±1.25)分,随访终末评分(13.70±1.33)分,手术前后JOA评分具有显著性差异(P<0.05)。VAS评分:术前评分(6.85±1.18)分,随访终末评分(2.15±1.30)分,手术前后VAS评分具有显著性差异(P<0.05)。术后12个月植骨融合率为100%;术前Cobb角为10.3°(-5°～16°),随访终末Cobb角为15.5°(0°～20.5°);术后均无感染、喉返神经、喉上神经及椎动脉损伤,切口均一期愈合;无翻修手术者。结论经前路颈椎间孔减压植骨融合内固定术治疗神经根型颈椎病具有创伤小、减压直接、疗效确切的优点。

Objective To evaluate the therapeutic effect of anterior cervical foraminal decompression and fusion and internal fixation in cervical spondylotic radiculopathy.Methods Retrospective analysis of 21 patients with cervical spondylotic radiculopathy who undergoing surgery of anterior cervical foraminal decompression and fusion and internal fixation from January 2005 to December 2008.The JOA and VAS were assessed before and immediately,6 months and 18 months after operation.Results A total of 21patients were included.Before the operation,the JOA score was（8.50±1.25） points,and it increased to（13.70±1.33） points at the time of follow-up terminal（P0.05）.The VAS assessment decrease to（2.15±1.30） points at the time of follow-up terminal,which was significantly different from before（6.85±1.18 points）.The fusion rate was 100%12 months after the surgery;the patients′ preoperative Cobb angle was 10.3 °（-5°～16°） and increased to 15.5°（0°～20.5°） at the time of follow-up terminal;there were no postoperative infections and injuries of throat back nerve,superior laryngeal nerve and vertebral artery were accrued,wound healing were Ⅰ;no re-operation accrued.Conclusion Anterior cervical foraminal decompression and fusion fixation of cervical spondylotic radiculopathy was an effective operation with less trauma and direct decompression effect.