颈前路椎体次全切减压植骨内固定术治疗双节段脊髓型颈椎病中远期随访

Effect of Anterior Cervical Corpectomy with Titanium Mesh Fusion and Internal Fixation in the Treatment of Double Segment Cervical Spondylotic Myelopathy

目的：回顾分析颈前路椎体次全切减压植骨内固定术治疗双节段脊髓型颈椎病的中远期疗效。方法：回顾我院自2008～2011年采用颈前路椎体次全切减压植骨内固定术治疗双节段脊髓型颈椎病患者43例的临床资料。采用SPSS18．0软件对患者术前、术后、末次随访时JOA评分、颈椎生理弯曲与椎间高度比较进行统计学分析。结果：平均随访3．5年（2—5年），所有患者术前术后JOA评分术前平均8．5±1．4分，术后JOA评分12．5±1．3分，末次JOA评分14．5±1．3分。患者术前术后JOA评分差异有统计学意义（P〈0．05）；末次随访与术前JOA评分差异有统计学意义（P〈0．05），神经改善率优良率83．72％，患者术后颈椎生理曲度较术前有明显恢复，患者术前术后颈椎生理弯曲差异有统计学意义（P〈0．05），末次随访与术前颈椎生理弯曲差异有统计学意义（P〈0．05），而且患者术后椎间高度较术前有明显改善。结论：颈前路椎体次全切减压植骨内固定术治疗双节段颈椎病能够明显改善患者神经功能，稳定颈椎，恢复颈椎生理弯曲度及椎间高度，而且中远期疗效确实。

OBJECTIVE： To Retrospective and analysis the effect of anterior cervical corpectomy with titanium mesh fusion and internal fixation in the treatment of double segment cervical spondylotic myelopathy. METHODS ： From 2008 - 2011 Clinical data of 43 cases with cervical myelopathy treated by using the subtotal anterior decompression therapy double graft fixation patients were analysised. Using SAS6. 12 software preoperative, postoperative JOA score last follow - up analysised the results between the cervical physiological curvature and cone height comparison statistically. RESULTS ： After the average follow - up of 3.5 years （ 2 - 5 years） all patients JOA scores were 9. 1 ＋ 2.4 points before and after surgery, postoperative JOA score was 11. 4 ± 1.4 points, and the last JOA score 14. 5 ± 1.3 points. There was statistically significant difference in JOA score before and after operation （ P 〈 0. 05 ） ; There were significant statistically difference in JOA scores in the last follow - up and before operation （ P 〈 0. 05 ）. Neurological improvement rate was 83.72%. Postoperative cervical lordosis significantly recoveried compared with preoperative ones. There were statiseally sig- nificant differences in Cervical physiological bending before and after operation （ P 〈 0. 05 ）. There were statiscally significant differ- ences in physiological bending before operation and in the last follow - up （ P 〈 0. 05 ）. Patients intervertebral height improved more significantly after operation than that before operation. CONCLUSION： Anterior cervical decompression and subtotal double segment graft fixation in the treatment of cervical disease can significantly improve neurological function in patients with stable cervical spine.