颈椎退变合并反曲畸形的手术治疗

Correction of cervical kyphosis complicated with degenerative spondylosis by anterior operation

目的 探讨颈前路撑开的矫形方式在治疗颈椎退变合并反曲畸形中的作用。方法 34例颈椎退变合并反曲畸形的患者分为可回复性和难回复性两组。手术采用颈前路椎体次全切除、减压 ,然后应用前路撑开技术矫正反曲畸形。结果 31例获得平均 2 9个月随访。根据Odom标准 ,优良率81%。所有患者都未发生与手术有关的并发症。术前颈椎平均反曲角度为 2 2 6°,术后平均矫正了16 2° ,随访时平均矫正了 14 7°。 13例可回复型病例 ,术前平均反曲角度为 2 5 8° ,术后平均矫正了19 9° ,随访时平均矫正了 19 1°;18例难回复型病例 ,术前平均反曲角度为 2 0 6° ,术后平均矫正了13 9° ,随访时平均矫正了 11 4°。

Objective To evaluate the effectiveness of anterior subtotal corpectomy and distractive technique in correction of cervical kyphosis. Methods 34 patients with cervical kyphosis complicated with degenerative spondylosis underwent anterior decompression and correction using interbody distraction device, followed by routine autograft fusion. Results 31 patients underwent average 29 months follow up. The average preoperative cervical kyphosis of 22 6°was improved 16 2°after surgery and 14 7°at the final follow up. Patients with flexible kyphosis got better results compared with those with rigid or fixed kyphosis. Conclusion Anterior decompression combined with distractive technique can effectively correct the cervical kyphosis caused by degenerative spondylosis, especially for flexible deformity. This procedure is safe, effective and not associated with high incidence of complication.