颈椎前路不同手术方式减压融合内固定治疗脊髓型颈椎病临床分析

Clinical Analysis of Different Methods of Anterior Cervical Decompression and Internal Fixation for Cervical Spondylotic Myelopathy

目的：探讨前路不同手术减压方式治疗脊髓型颈椎病的临床疗效.方法：我院2012年10月～2015年12月对40例脊髓型颈椎病患者,选择性采用颈椎前路椎间隙减压融合术（ACDF）、椎体次全切减压融合术（ACCF）及椎间隙结合椎体次全切减压融合内固定术（ACHDF）3种不同手术方式减压融合内固定治疗,术后随访6～26个月,观察其疗效.结果：40例患者经过治疗后,按JOA评分法评价手术疗效,优良率为85.9%（35/40）;植骨融合率为100%.结论：根据脊髓受压程度、范围、影像学资料及患者体征,合理选择颈椎前路3种不同手术方式减压融合内固定治疗脊髓型颈椎病安全有效,临床效果满意.

Objective： The purpose of this study was to analyze the clinical effect of different methods of anterior cervical decompres- sion and internal fixation for cervical spondylotic myelopathy. Methods： We retrospectively reviewed 40 patients with cervical spondylotic myelopathy who underwent anterior cervical discectomy and fusion （ACDF） or anterior cervical corpectomy and fusion （ACCF） or hybird of both from October 2012 to December 2015. The JOA score was used to compare the outcome before and after surgery. Results： 40 Patients were followed up for 6 to 26 months. The excellent and good rate of improved JOA score was 85.9% （35/40）, and bone graft fusion rate was 100%. Conclusion：An appropriate choice of three different cervical anterior approaches should be made according to the de- gree and range of spinal cord compression, imaging data and patient signs. And decompression, fusion, and internal fixation by these techniaues in the treatment of cervical spondylotic myelopathy were safe and effective.