2种颈前路减压方法治疗相邻双间隙脊髓型颈椎病的疗效对比

Comparison of two surgical methods on double-segment cervical spondylotic myelopathy by anterior decompression

目的总结2种颈前路减压方法治疗相邻双椎间隙脊髓型颈椎病的临床疗效。方法对自2005-06—2010-06诊治的相邻双间隙脊髓型颈椎病28例采用2种不同的前路减压治疗并随机分成2组。观察神经功能Frankel分级、椎间隙改变等情况。结果有27例得到随访平均28个月。神经功能Frankel分级恢复情况：椎体次全切除减压组14例,C级2例中1例恢复至E级、1例恢复至D级,D级12例均恢复至E级。拱桥式减压组13例,D级13例中10例恢复至E级,3例改变不明显。椎间植骨均于12-18周达到骨性融合,椎间高度、生理曲度及颈椎稳定性均维持良好。结论前路椎体次全切除减压术较前路拱桥式减压术临床疗效更加安全可靠。

Objective To compare the effect of two surgical methods on double-segment cervical spondylotic myelopathy by anterior decompression. Methods From June 2005 to June 2010, 28 patients with double-segment cervical spondylotic myelopathy （C3-7） were divided into two groups： 14 patients were operated with anterior decompression of arch bridge and internal fixation, the other 14 patients were operated with subtotal vertebreetomy. Frankel functional score, the height of intervertebral disc, ere were observed. Results Twenty seven of 28 patients were followed-up for 28 months averaged. Of subtotal vertebrectomy group, 1 patient recovered from grade C to grade E, 1 patient recovered from grade C to grade D, 12 patients recovered from grade D to grade E. Of arch bridge decompression group, 10 patients recovered from grade D to grade E, 3 patients did not improve. Intervertebral fusion was found by X-ray postoperative 12-18 weeks. The height of intervertebral disc, physiological curvature, stability of cervical spine remained well. Conclusion Subtotal vertebreetomy and internal fixation fits for all type of double-segment cervical spondylotic myelopathy, which is more salty than arch bridge decompression.