前路椎体骨化物复合体前移融合术治疗颈椎椎管狭窄症合并巨大椎间盘突出

Anterior controllable antedisplacement and fusion for cervical spinal canal stenosis with giant disc herniation

目的探讨前路椎体骨化物复合体前移融合术(ACAF)治疗颈椎椎管狭窄症合并巨大椎间盘突出的临床疗效。方法回顾性分析2017年5月—2018年9月采用ACAF治疗的10例颈椎椎管狭窄症合并巨大椎间盘突出患者临床资料。对患者手术前后临床表现、日本骨科学会(JOA)评分、MRI影像学变化及并发症发生情况进行总结分析。结果所有手术顺利完成。患者术后未发生神经系统症状加重、感染等并发症;术后脊髓功能恢复显著,四肢肌力和运动功能明显改善;随访期间未发生植骨块松动和内固定失败现象。所有患者术后复查MRI,提示减压充分,T2加权像示脑脊液充盈良好,硬膜囊压迹基本消失,但高信号区仍存在。结论ACAF治疗颈椎椎管狭窄症合并巨大椎间盘突出效果确切,可显著改善患者的神经功能。

Objective To investigate the clinical effect of anterior controllable antedisplacement and fusion(ACAF) in the treatment of cervical spinal stenosis with giant disc herniation.Methods The clinical data of 10 patients with cervical spinal stenosis and giant disc herniation treated with ACAF from May 2017 to September 2018 were retrospectively analyzed. The clinical manifestations,Japanese Orthopaedic Association(JOA) score,MRI image changes and complications were summarized and analyzed.Results All the operations were successfully completed.No complications such as aggravation of nervous system symptoms and infection occurred after operation.The recovery of spinal cord function was remarkable after operation,and the muscle strength and motor function of limbs were improved significantly.No bone graft loosening and internal fixation failure occurred during the follow-up period.Postoperative MRI showed that all the patients had adequate decompression. T2 weighted images showed that cerebrospinal fluid was well filled and dural sac impression almost disappeared,but high signal areas still existed.Conclusion ACAF is effective in the treatment of cervical spinal stenosis with giant disc herniation,and can significantly improve the patients’ neurological function.