多平面脊髓型颈椎病的手术治疗及远期疗效分析

Surgical treatment and long-term results of multileve cervical spondylotic myelopathy

95例多平面脊髓型颈椎病患者手术治疗后,平均随访4年,74例(77.9%)有效,其中55例(57.9%)疗效显著,15例(15.8%)完全恢复正常。我们认为:受累平面较少、症状较明显、年龄较轻者,疗效较好;对2个平面受累的患者,既可行 Cloward 前路减压,也可作椎体次全切除;受累平面在3个以上者,宜取椎体次全切除;椎管明显狭窄或脊髓受压因素源自后方者,可行椎管扩大。

95 patients of multilevel cervical spondyloticathy were treated by surgery.The mean foll-owed-up time was four years.74 cases(77.9%)showedeffective and 55 cases(57.9%).showed markedimprovement.15 patients recovered completely.Therelations between results and sex.age.duration ofsymptoms,severity of disease,number of involvedlevels and surgical approach,were analysed.Theresults were rather good in younger patients withmarked symptoms and less involved levels.Inpatients with two-level myelopathy Cloward anterior,decompression and spinal fusion may be performed, subtotal vertebrectomy could be carried also.If thepatients were involved beyond three levels subtotalvertebrectomy is the best choice.In patients withnarrow spinal canal or the compression fromposterior aspect of the spinal cord expansivelamino-plasty may be performed.