保留椎体后壁的椎体次全切除联合椎间隙减压治疗多节段颈椎病

方法探讨保留椎体后壁的椎体次全切除联合椎间隙减压治疗多节段颈椎病的临床疗效。方法2011年2月至2013年1月，采用保留椎体后壁的椎体次全切除联合椎间隙减压治疗多节段颈椎病19例，术后1、3、6、12个月分别摄x线片、3个月时行颈椎CT三维重建了解内固定在位及植骨融合情况，并记录患者神经功能评分。结果所有患者均获得8~16个月的随访（平均10．6个月）；19例患者术前JOA评分为（10．40±1．09）分，末次随访评分为（15．46±1．15）分，差异有统计学意义（P〈0．01）；其中优9例，良7例，有效3例，优良率为84．2％；术后3~4个月植骨全部融合，无钢板松动、钛网或LCage移位、椎体塌陷、假关节形成等并发症发生；2例出现声音嘶哑，2~3周后自愈。结论保留椎体后壁的椎体次全切除联合椎间隙减压治疗多节段颈椎病，具有疗效满意、操作安全、减压彻底及植骨融合可靠、术后并发症少等优点。

Objective To study the effect ofcervical subtotal corpectomy with the posterior vertebral wall retention combinedwithintervertebral decompression for multi-level （≥ 3 ） cervical spondylosis .Methods 19 cases of multi-level （ I〉 3 ） cervical spondylosis were treated with subtotal corpectomy with the posterior vertebral wall retention combinedwithintervertebral decompressionfrom 2011 February to 2013 January. Bone fusions were assessed with roentgenogram and CT during the 1st, 3rd, 6th, 12th month follow-up and neurologic function was recorded. Results All patients were followed-up 8-16 months with an average of 10.6 months. The JOA score （ 15.4±1.15 ） at last follow-upwas significantly improved when compared with preoperative score （ 10.40 ± 1.09 ） , showing significant difference （P〈0.01） .Of which 9 cases were excellent, good in 7 cases, effective in 3 cases, the excellent and good rate was 84.2%.Bone fusion happened in all patients 3 to 4 months after operation. The complications that plate loosening, titanium mesh or cage shift, vertebral collapse, pseudoarticulation formation were not found. 2 patients with hoarseness recovered 2-3 weeks later. Conclusion For multi-level cervical spondylosis, subtotalcorpectomy with the posteriorvertebral wall retention combinedwithintervertebral decompression was a feasible anterior decompression procedure with advantage of safety, completely decompression and reliable bone fusion.