前后路联合手术治疗脊髓型颈椎病50例临床分析

Combined anterior and posterior operation in the treatment of 50 cases with cervical spondylotic myelopathy

目的 探讨前后路联合手术治疗脊髓型颈椎病的临床疗效.方法 50例脊髓型颈椎病患者按照前路手术、后路手术和前后路联合手术三种不同的手术方法,将就诊患者分为A组、B组、C组,三个组例数分别为21例、16例、13例,对三组患者分别进行手术疗效分析.结果 三组治疗前JOA评分差异均无统计学意义[C组（9.3±2.3）分,B组（9.4±1.4）分,A组（9.2±2.2）分];治疗后,C组[（14.5±3.4）分]明显高于A组[（12.6±1.2）分]（t=3.09,P＜0.0S）和B组[（11.3±1.4）分]（t=4.62,P＜0.05）;C组术后优良率（76.9％）明显高于A组（43.8％）（x2=3.84,P＜0.05）和B组（42.8％）（x2=4.11,P＜0.05）.结论 采取前后路联合治疗脊髓型颈椎病,脊髓功能恢复较好,具有减压彻底、疗效显著、手术并发症少等特点.

Objective To explore the clinical efficacy of combined anterior and posterior operation in the treatment of cervical spondylotic myelopathy. Methods 50 patients with cervical spondylotic myelopathy,in accord- ance with anterior, posterior surgery and combined anterior and posterior operation three different surgical methods, were divided into the treatment group A（21 cases）, group B（ 16 cases） and group C（ 13 cases）. The surgical effica- cy was analyzed. Results Before treatment, the JOA score among the three groups had no significant difference [ C group （9.3 ＋ 2.3 ） points, B group （9.4 -＋ 1.4） points, A group （9.2 ＋ 2.2 ） points ]. After treatment, the JOA score in group C （ 14.5 -＋ 3.4 ） points was significantly higher than that of group A （ 12.6 -＋ 1.2 ） points （ t -- 3.09, P 〈 0. 05 ） and group B （ I I. 3 ＋ 1.4 ） points （t = 4.62,P 〈 0.05 ）. The excellent and good rate of C group was 76.9%, which was significantly higher than that in group A 43.8% （ X2 = 3.84 ,P 〈 0.05 ） and group B 42.8% （ X2 = 4.11, P 〈 0.05 ）. Conclusion Combined anterior and posterior operation in the treatment of cervical spondylotic myelopa- thy has better recovery of spinal cord function, complete decompression, significant effect, less complications, etc. , it is an effective, safe and reliable treatment.