颈椎前路融合手术后邻近节段退变原因分析

Analysis of partment of adjacent segment degeneration after anterior cervical fusion

目的探讨颈椎前路融合术后邻近节段椎间盘退变的原因及其防治办法。方法对颈椎前路融合术后70例患者的临床资料进行回顾性分析，探讨术中可能导致颈椎前路融合术后邻近椎间盘退变突出的原因。结果随访时间10个月～7年，平均5．6年。17例颈椎间盘突出症患者发生邻近节段椎间盘退变加重，其中2例患者伴有明显的临床症状，未再次手术。结论临床手术中可主观避免的导致ASD加重的可能因素：①术中尽量恢复较好的颈椎的生理曲度；②建议钢板放置距离邻近椎间隙至少5mm；③避免术中大范围剥离损伤前纵韧带及纤维环，避免定位针刺破正常邻近节段纤维环。

Objective To investigate the cause of the adjacent segment degeneration after anterior cervical decompression and fusion and search for the way of prevention. Methods To give a retro- spective study to 70 patients who accepted anterior cervical decompression and fusion, discuss the possible cause of adjacent segment degeneration in operating. Results The follow up was from 10 months to 7 years, 5.6 years in average. The 17 patients suffered the adjacent segment degeneration, in which 2 patients suffered clinic obvious symptom, no reoperation. Conclusions The possible causes of adjacent segment degeneration in operating include： ①To recover the cervical physiological curvature in operation ; ②The fixation plate is apart from adjacent intervertebral disc at least 5 mm; ③To avoid damnifying the anterior longitudinal and annulus of adjacent segment.