脊髓型颈椎病外科治疗的远期疗效评价

Evaluation of long-term outcome of surgical treatment for cervical spondylotic myelopathy

目的 :研究脊髓型颈椎病经前路减压及植骨融合术后的远期疗效及其影响因素。 方法 :对 2 45例脊髓型颈椎病患者 ,实施颈前路减压及自体髂骨移植融合 ,其中 3 1例于术后 6个月至 4年再次手术。术后随访 5 -15年 ,平均随访时间 6.8年。结果 :术后功能评价 ,优 118例 ( 4 8.16% ) ,良 71例 ( 2 8.98% ) ,可 3 5例 ( 14 .2 9% )及差 2 1例 ( 8.5 7% )。根据 40分评分法 ,3 6-4 0分者 10 1例 ,3 1-3 5分者 5 4例 ,平均提高 8分。 结论 :脊髓型颈椎病外科治疗远期效果是肯定的 ;手术时机。

Objective: To investigate the long term outcome of anterior decompression and bone graft fusion for cervical spondylotic myelopathy(CSM) and factors affecting the outcome. Methods: Two hundred and forty five patients with CSM were treated with anterior cervical decompression and auto iliac bone graft fusion, of whom 31 had a second operation between 4 months and 2 years after operation. Follow up studies were carried out within 5 to 15 years after operation, averaging 6.8 years. Results: Function evaluation: excellent in 118 cases (48.16%), good in 71 (28.98%), passable in 35 (14.29%) and poor in 21 (8.57%). According to the 40 points score method, there was an average of 8 point increase in all cases, of which 101 were between 36 to 40 points, 54 between 31 to 35 points. Conclusion: The long term outcome of surgical treatment for CSM is definite. Significant factors affecting the outcome include timing of operation, degree of pathology and technique of surgery.