钩椎关节骨赘切除前路颈椎减压椎间融合术治疗重症颈椎病(附112例远期疗效分析)

Anterior Decompression,Remove of Luschks Joint Osteophytes and Intervertebrae Fusion for Surgical Treatment on Cervical Spondylosis in Serious Patients(Analysis of Long Term Results for 112 Cases)

目的 探讨对以切除钩椎关节椎后增生骨赘一切致压物为主的颈椎前路减压、椎间植骨融合术治疗重症颈椎病手术的远期疗效。方法 确诊后 ,手术部位在局麻加颈丛麻醉下进行 ,术中全部使用我们设计的JZ— 1型颈椎病特殊器械行前路病椎椎间盘切除、钩椎关节骨赘刮除、取自体髂骨作植骨 ,融合椎间盘及稳定椎体 ,应用于严重的各种不同的压迫型颈椎病 (神经根型、脊髓型、椎动脉型、OALL型及创伤型颈椎病 )。结果 手术共实施 1 1 2例各型颈椎病 ,按型施术。经 7年 5个月～ 1 8年的远期随访 ,经分级标准分析优良率达 96 4% ,术后大部分已康复。结论 颈椎病由于解剖、生理学上的特殊 ,手术时既要应用精确的手术器械 ,讲究手术技巧 ,消除术中震荡及副损伤 ,又要解除主要致病因素和缩短术程。掌握有关颈椎病微细解剖结构及主要的神经血管配布 ,处理好术中意外情况 ,减少出血 。

Objective To analyse the clinical results of surgical treatment on cervical spondylosis with long term follow up evaluation.Methods The operating methods were to remove the increased parts of Luschks joint, the cervical degeneration disc and osteophytes of the posterior cervical vertebrae.Anterior decompression and intervertebrae bone graft fusion were performed with JZ-I type instruments.Indications included serious nerve root type, spinal cord type cervical spondylotic myelopathy,vertebrae artery type,OALL (Ossification of the anterior Longitudinal Ligament) type and traumatic type of cervical spondylosis.Results In surgical treated 112 cases of any type of cervical spondylosis, they were followed up 7 years and 5 months ～18 years.The rate of the excellent and good was 96.4% and most of them restored.Conclusion Because of the characteristic of the anatomy and physiology of cervical spondylosis,so the topographical anatomical details, especially the understanding of the course of the arteries are most important in reducing bleeding and simplifying the operation procedure and it is adopt particular about advanced techniques. The new operation instruments is more helpful in preventing excessive shake and injury during operation so as to avoid accidents in operating,this technical innovation will save us much time and raise the successful rate of operation.