一期前后路联合手术治疗颈胸段脊柱病变的临床疗效分析

The clinical efficacy analysis of combined anterior and posterior approach for the treatment of cervical and thoracic spinal lesions

目的:探讨一期前后路联合手术治疗颈胸段脊柱病变的临床疗效。方法:分析42例颈胸段脊柱病变患者的手术资料,分别于术前、术后及随访12个月后,复查X线及CT等影像检查,记录JOA评分及Cobb角,综合判断患者病变控制、植骨融合情况。结果:患者术后Cobb角为(8.8±2.6),12个月随访后Cobb角为(9.3±3.1),与术前比较改善明显,差异具有统计学意义(P<0.05)。患者术后JOA评分为(14.2±3.4)分,12个月随访后JOA评分为(14.6±2.9)分,与术前比较改善明显,差异具有统计学意义(P<0.05)。患者术后脊髓神经功能分级为:C级5例,D级7例,E级30例。结论:采用一期前后路联合手术治疗颈胸段脊柱病变的临床疗效确切,具有较大的应用价值。

Objective To evaluate the clinical effect of one-stage anterior and posterior approach in the treatment of cervical and thoracic spine lesions. Method To analyze the surgical data of our hospital 42 cases of cervicothoracic spinal lesions,respectively before and after surgery and after 12 months of follow-up,X-ray and CT examinations,record the JOA score and Cobb angle,the comprehensive judgment and control lesions in patients with bone graft fusion. Results The angle of Cobb after operation was（ 8. 8 ± 2. 6）. After 12 months follow-up,the angle of Cobb was（ 9. 3 ± 3. 1）,and compared with that before operation,the difference was statistically significant（ P〈 0. 05）. The postoperative JOA score was（ 14. 2 ± 3. 4） points,and after 12 months follow-up,the JOA score was（ 14. 6 ± 2. 9） points,which improved significantly compared with the preoperative,and the difference was statistically significant（ P〈 0. 05）. The grading of spinal nerve function in patients after operation was C grade 5 cases,grade D 7 cases,grade E 30 cases. Conclusion The one-stage combined anterior and posterior approaches for the treatment of cervicothoracic spinal and thoracic spine lesions is of definite clinical efficacy and is of great practical value.