前路槽式减压植骨钢板内固定治疗脊髓型颈椎病

Anterior trough decompression and autograft with cervical spine locking plate for cervical spondylosis myelopathy

目的 探讨前路槽式减压植骨内固定手术在治疗脊髓型颈椎病中的应用价值。方法 对19例脊髓型颈椎病患者行前路槽式减压自体髂骨移植加钢板内固定术 ,其中单节段2例、2节段15例、3节段2例。并对术后临床症状及X线表现进行分析。结果 19例平均随访8.9个月 ,18例四肢麻木于术后3d～22周消失 ,17例行走困难于术后2～24周消失或明显好转 ,11例深反射亢进于术后3～16周基本恢复正常。椎间隙于术后8～12周骨性融合。1例钢板螺钉松动 ,无神经症状加重、颈椎反曲畸形及钢板螺钉断裂等并发症发生。结论前路槽式减压植骨钢板内固定治疗脊髓型颈椎病疗效肯定 。

Objective To investigate the practical value of anterior trough decompression and autograft with cervical spine locking plate(CSLP) for cervical spondylosis myelopathy(CSM). Method Nineteen patients with CSM underwent anterior decompression, autograft and internal fixation operation, including single-segment in 2, two-segment in 15, three-segment in 2. Postopertive clinical symptoms and radiographs of the cervical spine were analysed. Results The followed-up was 8.9 months in average. After operation, numbness of 18 cases vanished from 3 days to 22 weeks, walking with difficulty of 17 disappeared from 2 to 24 weeks, excessive deep reflex of 11 recovered from 3 to 16 weeks. Vertebral spaces comfluence within 8 to 12 weeks postoperatively. Plate and screws loosing was found in 1 case. No neutral symptoms aggravation, kyphosis deformity and hardware breakage occurred. Conclusion Curative effect of anterior decompression and autograft with CSLP fixation for CSM is definitive, but late complications need further observated.