颈椎前路钢板在脊髓型颈椎病前路手术中的作用

The effect of locking plate in anterior decompression for cervical spondylotic myelopathy

目的 评价内固定在脊髓型颈椎病前路减压中的作用。方法 143例脊髓型颈椎病患者经前路减压后自体髂骨植骨 ,带锁钢板内固定。获得随访病例 132例 ,随访时间平均 2 0个月 ,观察术后神经功能恢复情况 ,植骨融合率 ,椎间高度及颈椎生理曲度恢复情况。结果 单节段与两节段病变者术后 3月均获得骨性愈合 ,融合率为 10 0 %,16例 3节段病变者融合体为 81.3%,内固定并发症为 5 / 132 ( 3.8%)。术后椎间高度与生理曲度均获得满意重建。JOA记分平均改善率 6 5 .8%。结论 在脊髓型颈椎病前路减压手术中应用带锁钢板内固定可有效维持椎间高度和生理曲度 ,并有助于后路间接减压。

Objective To evaluate the effect of locking plate in anterior decompression and fusion for cervical spondylotic myelopathy (CSM).Methods 143 cases of CSM were treated with a combined operation of anterior decompression,fusion with iliac crest autograft and cervical spine locking plate,132 cases were followed up to evaluate the rehabilitation of the neurological function,to investigate the fusion rate of bone-graft,the height of interbody space,the maintaining condition of cervical spine lordosis with an average follow-up of 20 months.Results the patients with 1 and 2-level lesions had(100%) bony fusion in 3 months after operation.Whereas 16 cases with 3-level lesions showed a fusion rate of 87%.There were 5 cases with complications of implanted materials(3.8%).All cases gained satisfied recovery of height of involved interbody space and lordosis. The average JOA scale improved with an average rate 65.8%.Conclusion The internal fixation with locking plate in anterior operation in CSM can effectively improve the recovery of involved interbody height and cervical lordosis and has indirect decompression effect for posterior flavum ligament.