一期前后路联合手术治疗多节段前后受压的脊髓型颈椎病

Clamp-type cervical spondylosis treated by surgery that combines anterior and posterior approaches

目的探讨一期前后路联合手术治疗多节段前后受压的脊髓型颈椎病疗效。方法对28例前后方同时受压的严重颈椎病患者,采用一期前路减压(椎间盘摘除或椎体次全切除)、自体髂骨植骨或钛笼自体骨植骨、颈前钢板固定,后路单开门丝线缝合或CENTER PIECE固定,观察脊髓功能恢复情况、颈椎稳定情况及植骨融合率。结果随访12～36个月,平均13.7个月,28例皆获得骨性愈合,术后融合节段稳定,颈椎生理曲度得到良好重建及维持,脊髓功能均有不同程度恢复。结论一期前后路联合手术治疗前后受压的严重脊髓型颈椎病有助于脊髓的功能恢复及颈椎稳定性的重建。

Objective To investigate the efficacy of operation that combines anterior and posterior approaches in treatment of clamp - type cervical spondylosis. Methods From January 2008 to January 2010, twenty - eight patients with severe pressure on both sides of cervical spondylosis were treated with decompression（ discoidectomy or vertebsectomy） , autologous iliac bone grafting or titanium cage with autologous bone graft, anterior micro -plate, posterior single door and finished with silk thread suture or CENTER PIECE fixation. Functional recovery and cervical spinal cord stability were observed before and after operation. Results Followed up for 12 -36 months ,all of the twentyeight patients achieved bone healing. The stability of injured segments was improved,intervertebral space, cervical lordosis reconstruction and maintenance were good, and spinal cord function was recovered. Conclusions Combined anterior and posterior treatment of severe cervical spondylosis contributes to the stability of functional recovery and reconstruction of cervical vertebrae.