颈前路显微外科手术治疗脊髓型颈椎病.doc

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1、颈前路显微外科手术治疗脊髓型颈椎病【关键词】椎间盘切除　　摘要：［目的］探讨前路显微外科减压椎体融合钢板固定术治疗脊髓型颈椎病。［方法］对61例病人实施颈椎间盘、后纵韧带及椎体后骨赘显微手术切除，保留终板，椎间融合器椎体融合，钢板固定手术。术后平均随访182个月。分析融合情况、融合节段的后突角度及神经功能状况。［结果］融合率100％。术后神经功能改善率(825±36）％，优良率737％。融合节段后突角度平均改善63°，有统计学意义(P＜001）。［结论］颈前入路显微外科手术治疗1~2个节段椎间盘突出和（或）

2、退行性骨赘引起的脊髓型颈椎病安全可行，近期疗效满意。保留终板的椎间融合器椎体融合加钢板固定手术能恢复和维持颈椎生理曲度，促进融合。　　关键词：显微手术；脊髓型颈椎病；椎间盘切除；脊柱融合术；前路减压；钢板内固定　　Anteriormicrosurgericaldecompressionandintervertebralfusionwithplatingforcervicalspondyliticmyelopathy　　Abstract：［Objective］Tointroduceandevaluatethe

3、efficacyofanteriormicrosurgicaldecompressionandtitaniumcageimplantsfusionwithanteriorplatingincervicalspondyliticmyelopathy［Method］Aretrospectiveanalysiswasdonein61consecutivepatientswhounderwentanteriormicrosurgicaldecompressionfollowedbyintervertebralfus

4、ionbyusingatitaniumcagepackedwithautogenouscancellousbonegraftandananteriorcervicalplatingThebonyendplateswerepreservedtopreventcagesubsidenceFortyfourcaseswereoneleveland17casesweretwolevelsThefollowupperiodrangedfrom12to36months,withanaveragefollowupperi

5、odof182monthsFusionwasjudgedbythelessthan2mmmotionbetweenthespinousprocessesofthesurgicallymanagedlevelsonflexionextensionlateralradiographsThesegmentalkyphosispreoperativelyandlordosispostoperativelywasmeasuredwithCobbsmethodPreandpostoperativeneurologica

6、lstatuswereassessedbyusingthecervicalmyelopathyscoringsystemoftheJapaneseOrthopedicAssociation［Result］NopatientexperiencedseverecomplicationsTherewasradiographicevidenceoffusioninall61patientsImprovementratioofneurologicalstatuswas(825±36）%Excellentandgood

7、ratewas737%Segmentalsagittallordosiswassignificantlyimproved［Conclusion］Anteriorcervicalmicrosurgicaldecompresssionisasafeandeffectivetreatmentoptioninwellselectedpatientswithcervicalspondyliticmyelopathy,resultinginasignificantimprovementofneurologicalfun

8、ctionTitaniumcageinterbodyfusionwithconcomitantuseofanteriorplatingprovides5immediatebiomechanicalstability,cansuccessfullyrestoreandmaintainposteriorinterbodyheightandcervicallordosistoensuresatisfactorylong