Objective：To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods：One hundred and twenty patie...Objective：To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods：One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates. There were 66 men and 54 women ranges in age from 37 to 72 Years（mean age, 58.3 years）. The mean Japanese orthopedic surgery association（JOA） scale was 9.6 points before operation. Patients were followed up clinically and radiographically. Results：Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml. There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture. The average follow-up period was 14.3 months（range, 12 to 24 months） in 96 who were followed up. At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improvement of 4.8 points. The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. Stable bone union was observed in all cases and the average time required for fusion was 5.7 months. Conclusion：Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site. When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.展开更多
Objective:To investigate a novel surgical method for multilevel cervical spondylotic myeIopa- thy(CSM).Methods:Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2...Objective:To investigate a novel surgical method for multilevel cervical spondylotic myeIopa- thy(CSM).Methods:Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2004 were analyzed retrospectively.All patients experienced anterior cervical decompression surgery in subsection,autograft fusion and internal fixation.Preoperative,immediate post- operative and follow-up image data,X-rays and semi-quantitative Japanese orthopaedics association(JOA) scores were used to evaluate the restoration of lordosis(Cobb's angle),intervertebral heights,the stabili- ty of the cervical spine and the improvement of neurological impairment.Results:Preoperative symptoms were markedly alleviated or disappeared in most of the patients.According to the JOA scores,the ratio of improvement in neurological function was 72.2%,including excellent in 9 cases(42.9%),good in 7 cases (33.30%),fair in 3 cases(14.3%)and poor in 2 cases(9.5%).Immediate postoperative X-rays showed obvious improvements in lordosis and in the intervertebral height of the cervical spine(P<0.01).There is no evidence of instrument failure during the mean follow-up period of 14.2 months(9-24 months, P>0.01).Conclusion:Anterior cervical decompression in subsection,autograft fusion and internal fixa- tion is a rational effective method for the surgical treatment of multilevel CSM.展开更多
Objective To investigate diagnosis and treatment characters of cervical spondylotic myelopathy combined with thoracic spinal stenosis, and to analysis effective pathway of spinal function recovery. Methods We took res...Objective To investigate diagnosis and treatment characters of cervical spondylotic myelopathy combined with thoracic spinal stenosis, and to analysis effective pathway of spinal function recovery. Methods We took respective analysis on diagnosis, treatment and recovery results of 12 cases, whose symptoms, signs and MR were explicit. Results Follow ups times were from 9 months to 5 years and 8 months. Nerve function of 8 cases recovered completely or nearly completely; that of 2 cases improved apparently and that of 2 cases improved slightly. Conclusion Detailed disease history collection, particular body examination and MR reading are very important to early diagnosis of cervical spondylotic myelopathy combined with thoracic spinal stenosis. Early operation combined with cervical and thoracic spinal canal decompression at same time or at different stages is the single effective method to patients’ function recovery.展开更多
目的:分析比较不同颈前路减压术式治疗多节段脊髓型颈椎病术后并发症的差异。方法:回顾性分析2006年1月～2011年8月手术治疗的327例三节段脊髓型颈椎病患者的临床资料,根据手术方式不同分为三组:前路椎间盘切除减压融合术(anterior cerv...目的:分析比较不同颈前路减压术式治疗多节段脊髓型颈椎病术后并发症的差异。方法:回顾性分析2006年1月～2011年8月手术治疗的327例三节段脊髓型颈椎病患者的临床资料,根据手术方式不同分为三组:前路椎间盘切除减压融合术(anterior cervical discectomy with fusion,ACDF)(A组)、前路椎体切除减压融合术(anterior cervical corpectomy with fusion,ACCF)(B组)和ACDF+ACCF"混合式"减压术(C组),其中A组男性69例,女性55例,平均年龄53.48±8.50岁;B组男性51例,女性43例,平均年龄54.36±7.82岁;C组男性61例,女性48例,平均年龄53.68±7.80岁,组间比较无统计学差异。对三种不同手术方式并发症情况进行比较。结果:平均随访时间3.5年(1.5～5年)。共有69例在手术后出现多种并发症,包括植骨未融合11例,其中C组3例(2.75%),B组8例(8.51%),B组植骨不愈合发生率显著高于A组和C组(P<0.05);声音嘶哑12例,其中A组5例(4.03%),B组3例(3.19%),C组4例(3.67%);吞咽困难26例,其中A组11例(8.87%),B组7例(7.45%),C组8例(7.34%);C5神经根麻痹12例,其中A组2例(1.61%),B组5例(5.32%),C组5例(4.59%);脑脊液漏5例,其中A组3例,C组2例;切口感染3例,其中B组2例,C组1例。A组患者并发症发生率为16.94%,B组为26.60%,C组为21.10%,B组患者术后并发症的发生率显著高于其余两组(P<0.05)。结论:多节段脊髓型颈椎病患者手术治疗中,ACDF的并发症发生率最低,ACCF术式应慎用,其并发症的发生率较高。展开更多
文摘Objective：To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods：One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates. There were 66 men and 54 women ranges in age from 37 to 72 Years（mean age, 58.3 years）. The mean Japanese orthopedic surgery association（JOA） scale was 9.6 points before operation. Patients were followed up clinically and radiographically. Results：Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml. There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture. The average follow-up period was 14.3 months（range, 12 to 24 months） in 96 who were followed up. At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improvement of 4.8 points. The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. Stable bone union was observed in all cases and the average time required for fusion was 5.7 months. Conclusion：Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site. When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.
文摘Objective:To investigate a novel surgical method for multilevel cervical spondylotic myeIopa- thy(CSM).Methods:Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2004 were analyzed retrospectively.All patients experienced anterior cervical decompression surgery in subsection,autograft fusion and internal fixation.Preoperative,immediate post- operative and follow-up image data,X-rays and semi-quantitative Japanese orthopaedics association(JOA) scores were used to evaluate the restoration of lordosis(Cobb's angle),intervertebral heights,the stabili- ty of the cervical spine and the improvement of neurological impairment.Results:Preoperative symptoms were markedly alleviated or disappeared in most of the patients.According to the JOA scores,the ratio of improvement in neurological function was 72.2%,including excellent in 9 cases(42.9%),good in 7 cases (33.30%),fair in 3 cases(14.3%)and poor in 2 cases(9.5%).Immediate postoperative X-rays showed obvious improvements in lordosis and in the intervertebral height of the cervical spine(P<0.01).There is no evidence of instrument failure during the mean follow-up period of 14.2 months(9-24 months, P>0.01).Conclusion:Anterior cervical decompression in subsection,autograft fusion and internal fixa- tion is a rational effective method for the surgical treatment of multilevel CSM.
文摘Objective To investigate diagnosis and treatment characters of cervical spondylotic myelopathy combined with thoracic spinal stenosis, and to analysis effective pathway of spinal function recovery. Methods We took respective analysis on diagnosis, treatment and recovery results of 12 cases, whose symptoms, signs and MR were explicit. Results Follow ups times were from 9 months to 5 years and 8 months. Nerve function of 8 cases recovered completely or nearly completely; that of 2 cases improved apparently and that of 2 cases improved slightly. Conclusion Detailed disease history collection, particular body examination and MR reading are very important to early diagnosis of cervical spondylotic myelopathy combined with thoracic spinal stenosis. Early operation combined with cervical and thoracic spinal canal decompression at same time or at different stages is the single effective method to patients’ function recovery.
文摘目的:分析比较不同颈前路减压术式治疗多节段脊髓型颈椎病术后并发症的差异。方法:回顾性分析2006年1月～2011年8月手术治疗的327例三节段脊髓型颈椎病患者的临床资料,根据手术方式不同分为三组:前路椎间盘切除减压融合术(anterior cervical discectomy with fusion,ACDF)(A组)、前路椎体切除减压融合术(anterior cervical corpectomy with fusion,ACCF)(B组)和ACDF+ACCF"混合式"减压术(C组),其中A组男性69例,女性55例,平均年龄53.48±8.50岁;B组男性51例,女性43例,平均年龄54.36±7.82岁;C组男性61例,女性48例,平均年龄53.68±7.80岁,组间比较无统计学差异。对三种不同手术方式并发症情况进行比较。结果:平均随访时间3.5年(1.5～5年)。共有69例在手术后出现多种并发症,包括植骨未融合11例,其中C组3例(2.75%),B组8例(8.51%),B组植骨不愈合发生率显著高于A组和C组(P<0.05);声音嘶哑12例,其中A组5例(4.03%),B组3例(3.19%),C组4例(3.67%);吞咽困难26例,其中A组11例(8.87%),B组7例(7.45%),C组8例(7.34%);C5神经根麻痹12例,其中A组2例(1.61%),B组5例(5.32%),C组5例(4.59%);脑脊液漏5例,其中A组3例,C组2例;切口感染3例,其中B组2例,C组1例。A组患者并发症发生率为16.94%,B组为26.60%,C组为21.10%,B组患者术后并发症的发生率显著高于其余两组(P<0.05)。结论:多节段脊髓型颈椎病患者手术治疗中,ACDF的并发症发生率最低,ACCF术式应慎用,其并发症的发生率较高。
