前后路一期手术治疗老年重度脊髓型颈椎病

One-stage combined anterior-posterior decompression for severe cervical spondylotic myelopathy

目的探讨一期前后路联合手术治疗老年重度脊髓型颈椎病的临床效果。方法 12例诊断明确的老年重度脊髓型颈椎病患者,采用一期前后路联合减压术进行手术治疗。随访患者临床和影像学情况,按JOA评分标准评定神经功能,评价临床疗效。结果 12例患者手术顺利,手术时间4～7 h,平均4.6 h;术中出血量400～1400 ml,平均800 ml。随访4个月～3年,前路植骨及后路门轴全部骨性愈合,神经功能改善率均为优秀。结论对于前后均受压的老年重度脊髓型颈椎病患者,一期前后路联合减压手术可取得较好的临床疗效。

Objective To investigate the clinical effect of one-stage combined anterior-posterior decompression surgery in the treatment of elderly patients with severe cervical spondylotic myelopathy. Methods Twelve elderly patients with severe cervical spondylosis myelopathy were recruited, and they were treated by one-stage combined anterior-posterior decompression surgery. The clinical and imaging data of patients were followed-up, the nerve function was assessed according to the standards of the JOA score, and evaluating the clinical effect. Results All the surgeries were successful, the operation time was 4 -7 hours, the mean operative time was 4. 6 hours; The intraoperative blood loss was 400 - 1400 ml（ mean 800 ml）. Follow-up 4 months to 3 years, bone union was achieved in all anterior interbody and posterior hinged side, and the improvement rate of the nerve function was excellented. Conclusion For elderly patients with severe cervical spondylotic myelopathy before and after compression, one-stage combined anterior-posterior decompression surgery can achieve a better clinical efficacy.