显微镜下减压融合术治疗脊髓型颈椎病

Anterior cervical decompression and fusion by microscope for the treatment of cervical spondylotic myelopathy

目的:探讨显微镜下颈前路减压融合术治疗脊髓型颈椎病的疗效。方法:2005年2月至2010年3月,在显微镜辅助下经颈前路减压融合术治疗脊髓型颈椎病21例,男13例,女8例;年龄32～71岁,平均51.5岁;病程6个月～3年,平均12.5个月。手术操作:在显微镜下应用高速磨钻等工具进行减压操作,脊髓充分减压后取自体髂骨植骨融合加内固定。对手术前后JOA颈椎病评分进行比较并评价其疗效。结果:21例患者均获随访,时间18～24个月,平均20个月。患者脊髓神经功能均有不同程度提高,JOA评分由术前9.26±1.72增加至术后的13.64±1.38(t=2.452,P=0.000)。根据JOA评分评定疗效:优12例,良7例,一般2例。结论:显微镜下颈前路减压融合术具有操作精细、减压充分等优点,治疗脊髓型颈椎病安全、有效。

Objective： To explore clinical effects of anterior cervical decompression and fusion by microscope in treating cervical spondylotic myelopathy. Methods：From February 2005 to March 2010,21 patients with cervical spondylotic myelopathy, 13 males and 8 females with an average age of 51.5 years （ranged, 32 to 71 ） ,were treated with anterior cervical decompression using high-speed bur,then bone grafting and fusion with auto iliac bone and internal fixation by microscope. According to JOA score of cervical spondylosis to evaluate clinical effects before and after operation. Results ： All patients were followed up from 18 to 24 months with an average of 20 months. JOA score improved significantly from preoperative 9.26±1.72 to postoperative 13.64±1.38 （t=2.452,P=0.000）. According to JOA score, 12 cases were excellent,7 good and 2 fair. Conclusion：Anterior cervical decompression and fusion by microscope is a refined, safe and effective surgical procedure for cervical spondylotic myelopathy.