颈椎前路椎体次全切除钛网植骨融合内固定术治疗脊髓型颈椎病45例疗效分析

Anterior cervical corpectomy with titanium mesh fusion and internal fixation in the treatment of cervical spondylotic myelopathy of 45 cases

目的探讨颈椎前路椎体次全切除钛网植骨融合内固定术治疗脊髓型颈椎病的效果。方法收集2009年3月～2012年6月入住本院骨二科手术治疗脊髓型颈椎病患者45例,所有患者均采用前路椎体次全切除钛网植骨融合内固定术治疗;对其治疗效果及钛网植骨融合情况进行评价,采用JOA评分方法评价脊髓功能。结果 45例患者进行6～25个月的随访,平均15个月,无失访者。钛网植骨均在11周左右达到临床愈合,所有病例均在术后3d、12、24、48周行CT扫描,结果显示JOA脊髓功能评分由术前平均6.8分上升至术后13.5分,前后差异有统计学意义(t=3.172,P<0.05);钛网植骨均与上下椎体融合,可见骨小梁通过。结论颈椎前路椎体次全切除钛网植骨融合内固定术治疗脊髓型颈椎病的效果显著,是有效的治疗手段,且并发症少。

Objective To investigate the treatment effect of anterior cervical corpectomy with titanmm mesh Iuslon anO internal fixation in the treatment of cervical spondylotic myelopathy. Methods Forty-five cases of cervical spondylotie myelopathy patients from March 2009 to June 2012 in our hospital were selected. All the patients were treated with anterior corpectomy titanium mesh interbody fusion and internal fixation. Its therapeutic effect and titanium mesh and bone graft fusion was evaluated. JOA score method was used to evaluate spinal cord function. Results All patients were given 6 to 25 months follow-up, an average of 15 months, no missing respondents. Titanium mesh cage achieved clinical healing in about 1 l weeks, CT scan results in the postoperative 3 d, 12, 24 and 48 weeks showed JOA spinal cord function scores rose from 6.8 points before surgery to 13.5 points after surgery, the difference was statistically sig- nificant （t = 3.172, P 〈 0.05）, titanium mesh cage, the upper and lower vertebral body all fuse, trabecular bone is vis- ible. Conclusion The treatment effect of anterior cervical corpectomy with titanium mesh fusion and internal fixation is obvious, as the effective methods, the complications is also fewer.