颈前路椎体次全切除植骨钢板内固定术治疗多节段颈椎病

Subtotal vertebrectomy, autograft and plate fixation through anterior approach in the treatment of multisegmental cervical diseases

目的 探讨椎体次全切除减压植骨钢板内固定术在多节段颈椎病手术中的应用价值。方法 本组 2 4例颈椎病患者 ,累及椎间隙 2个 2 1例 ,3个 3例。均行颈前路椎体次全切除减压 ,取自体髂骨移植 ,并用颈前路纯钛钢板内固定。结果 本组均未发生术中并发症。对全部患者平均随访 2 2 .5个月。术后 6个月内植骨融合率 10 0 % ,无椎间高度再丢失 ,颈椎生理弧度维持良好 ;无钢板和螺钉松动或断裂。术后患者症状明显缓解 ,按Odom标准评定 ,优 15例 ,良 6例 ,可 3例。手术优良率为 87.5 %。结论 因减压彻底 ,颈前路椎体次全切除的手术效果好。植骨钢板内固定后 ,保证了颈椎术后的即时稳定性和植骨融合率。因此 。

Objective To evaluate the value of subtotal vertebrectomy, autograft and plate fixation in the treatment of multisegmental cervical diseases. Methods In 24 cases of cervical diseases of whom 21 involving 2 intervertebral spaces and 3 of 3 intervertebral spaces, through anterior approach subtotal vertebrectomy and iliac autograft with plate fixation was performed. Results There was no intraoperative complications. All 24 cases were followed up for 22.5 months. The postoperactive graft fusion rate was 100% within 6 months. There was no loss of intervertbral space. The physiological cervical curve was well maintained with no loosening or breakage of plates or screws.The symptoms of patients were significantly improved. According to the score of Odom, excellent was achieved in 15 cases, good in 6 and fair in 3. The excellent good rate was 87.5%. Conclusion Subtotal vertebrectomy through anterior approach gives complete decompression, good operative effect with the persistent autograft and plate fixation accompied maintaining the immediate postoperative stability and increasing graft fusion rate, therefore, this operative method has good prospect in clinical application.(Shanghai Med J,2002,25:575 577)