颈椎前路手术治疗脊髓型颈椎病的应用进展

Progress in the Application of Anterior Cervical Surgery in the Treatment of Cervical Spondylotic Myelopathy

经颈前路作为治疗脊髓型颈椎病的常用手术入路,主要包括颈前路椎体次全切除减压融合术与颈前路椎间盘切除减压融合术。目前上述手术方式已经成熟的应用于治疗脊髓型颈椎病,在临床上均取得了良好的手术效果,同时也存在着术中减压不充分、术后吞咽困难、术后内植物沉降率高、术后邻近椎体退变等一系列并发症。随着显微镜手术、微创手术及3D打印等技术及理念的发展,为颈椎前路手术方式增加了更多的临床思路,通过结合应用上述技术及理念,在改善患者症状的同时,力求最大限度降低各种手术并发症。因此,颈椎前路手术治疗脊髓型颈椎病手术术式的选择仍存在争议,本文章对目前颈椎前路各种治疗脊髓型颈椎病的手术方式进行综述,以期为脊柱外科医师使用颈前路手术治疗脊髓型颈椎病提供部分参考。

As a common surgical approach for the treatment of cervical spondylotic myelopathy, the anterior cervical approach mainly includes subtotal cervical vertebrae resection decompression fusion and anterior cervical discectomy decompression fusion. At present, the above two surgical methods have been maturely applied in the treatment of cervical spondylotic myelopathy requiring surgery, and have achieved good surgical results in clinical practice. At the same time, there are also a series of complications such as inadequate intraoperative decompression, postoperative dysphagia, high postoperative plant sedimentation rate, postoperative degeneration of adjacent vertebrae and so on. With the development of microscope surgery, minimally invasive surgery, 3D printing and other technologies and concepts, more clinical ideas have been added to the anterior cervical surgery. Through the combination of the above technologies and concepts, while improving the symptoms of patients, we strive to minimize various surgical complications. Therefore, the selection of surgical methods for the treatment of cervical spondylotic myelopathy by anterior cervical surgery is still controversial. This article reviews various surgical methods for the treatment of cervical spondylot-ic myelopathy by anterior cervical surgery, in order to provide partial reference for spinal surgeons to use anterior cervical surgery for the treatment of cervical spondylotic myelopathy.