经关节突螺钉固定治疗下颈椎退变性失稳的临床研究

Clinical Research of the Effect of Transarticular Screw Fixation for Degenerative Cervical Spine Instability

目的:探讨经关节螺钉固定治疗在下颈椎退行性不稳的稳定性重建的疗效。方法:2008年8月-2010年8月,收集17例退行性下颈椎不稳症患者。15例确诊为单节段不稳。病变节段C3/4节段1例,C4/5节段2例,C5/6节段7例,C6/7节段5例。2例确诊为双节段不稳,均为C5/6、C6/7。所有患者均出现临床症状,表现为:颈肩痛、眩晕或神经根压迫征、或上述症状并存。17例患者均行经关节突螺钉固定手术。结果:全部病例随访,随访时间12～28个月,平均14.7个月。术前JOA评分为(8.43±1.36)、术后为(14.81±3.21),差异有统计学意义(P<0.01)。结论:经颈后路关节螺钉固定可以有效的重建下颈椎的稳定性。其手术效果确切,安全可靠。

Objective To evaluate the curative effect of transarticular screw fixation in the proceed of stability renewal in patient with degenerative cervical spine instability.Methods 17 patients with unstable lower cervical spine degenerative disease were collected from August 2008 to August 2010,and among them 15 cases were diagnosed as single segment instability.Lesion segment is C3/4 segment in one case,C4/5 segment in two cases,C5/6 segment in seven cases,C6/7 segment in five cases.Two cases were diagnosed as double segment instability in C5/6 and C6/7.All patients showed up the following clinical symptoms,such as neck and shoulder pain,dizziness,and nerve root compression symptoms,or these symptoms coexisted.17 patients were treated with the facet screw fixation operation.Results All patients were followed up for 12 to 28 months,an average of 14.7 months.The preoperative JOA score is 8.43±1.36,and the postoperative JOA score is 14.81±3.21,the difference was statistically significant（P 〈 0.01）.Conclusion The posterior screw fixation operation can effectively rebuild the lower cervical spine stability and its curative effect is secure and reliable.