颈椎后路单开门联合前路选择性减压融合治疗多节段钳夹型脊髓型颈椎病的临床疗效

The clinical efficacy of posterior single open-door laminoplasty combined with selective anterior cervical decompression and fusion in the treatment of multi-level pinching cervical spondylotic myelopathy

目的探讨颈椎后路单开门联合前路选择性减压融合治疗多节段钳夹型脊髓型颈椎病的临床疗效。方法回顾分析2009-03-2012-06我科收治的24例钳夹型脊髓型颈椎病患者的资料,对比分析术前,末次随访JOA评分并观察颈部症状和活动情况。结果术前JOA评分平均8.7分,末次随访JOA评分平均14.9分.改善率74.4%,术后CT片示:植骨愈合良好,椎管矢状径明显扩大,MRI示脊髓受压解除。结论对于多节段钳夹型脊髓型颈椎病施行一期前后联合减压融合手术治疗疗效满意。

Objective To investigate the outcome of posterior single open-door ]aminoplasty combined with anterior cervical selective decompression with fusion treating multi-lcvcl pinching cervical spondylotic myelopathy. Methods A retrospective analysis was performed on 24 patients （male 16,female 8） with pinching cervical spondylotic myelopathy who received one-stage com- bined anterior-posterior cervical decompression and fusion. The mean age of these patients was 60 years old （range,35~71 years old）. 11 patients had three- level pinching cervical spondylotic myelopath,10 had 4 and 3 had 5. The follow up ranged from 6 to 24 months. Results The mean preoperative JOA score was 8.7,and the mean JOA scores of the last follow-up was 14.9. The im- provcmcnt rate was 74.4%. Thc outcomes of 14 patients （58.3%） were rated as vel~ good, 8 （33. 4%） as good,2 （8.3%） as fair and 0 as bad. Postoperative CT scans showed good fusion, en- larged cervical spinal canal;and MR1 showed decompressed spinal cord. Conclusion One-stage combined anterior-posterior cervical decompression and fusion could yield satisfactory outcome for the trealmenl of nmhi-level pinching cervical spondylotic myelopalhy.