选择性减压椎间融合器植骨治疗老年多节段颈椎病

Selective Decompression Fusion and Fixation with Interbody Cages in Treatment of Multisegmental Cervical Spondylosis in the Senile

目的:探讨选择性减压椎间融合器植骨治疗老年多节段颈椎病的可行性。方法:对46例年龄>60岁多节段颈椎病患者进行颈前路选择性减压、椎间融合器植骨融合内固定术后的疗效进行回顾分析。结果:术前该组病例JOA评分在6～13,平均9.2分。术后1个月该组病例JOA评分为7～16分,平均为15.3分,平均改善率为42.3％;术后3个月JOA评分为7～17分,平均改善率为54.4％;44例患者随访6～24个月,平均14.3个月,JOA评分为8～17分,平均改善率为65.3％。依据平林冽法评定其中优12例(27.2％),良18例(45.4％),可10例(22.7％),差4例(4.7)％。结论:选择性减压治疗老年多节段颈椎病有较好的疗效,以椎间融合器行椎间融合固定具有创伤小、固定节段少等优点,是治疗高龄多节段颈椎病的可选方法。

Objective: To study the feasibility and clinical outcomes of selective decompression, fusion and fixation with in-terbody cages in the treatment of multisegmental cervical spondylosis in the senile. Methods: A retrospective review of 46 patients (aged over 60 years) with multisegmental cervical spondylosis who underwent selective decompression, fusion and fixation with interbody cage was conducted. Results: The preoperative JOA score ranged from 6-13 points, with an average of 9.2. The score one month after the operation ranged from 7 to 16 points, with an average of 15.3, and on average the recovery rate was 54.4% ; 44 patients were followed up for 6-24 months, with a mean period of 14.3 months. JOA score ranged from 8-17 points. The mean recovery rate was 65.3% ; 12 of 44 were excellent, 18 good, 10 fair, 4 poor. Conclusion: Selective decompression for multisegmental CSM in the aged patients is a beneficial procedure. Fusion and fixation performed with interbody cage after decompression have the advantage of minor trauma and fewer fixed segments, thus minimizing the complication of pseudoarthorosis.