三种手术方法治疗脊髓型颈椎病的临床疗效

《三种手术方法治疗脊髓型颈椎病的临床疗效》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、三种手术方法治疗脊髓型颈椎病的临床疗效作者：刘艳兵，申勇，杨大龙，李志远，王林峰【摘要】[目的]探讨脊髓型颈椎病(CSM)的三种不同手术方式疗效。[方法]对2002年6月～2007年12月间在本院因CSM行颈椎手术治疗的患者111例，A组颈椎前路椎体次全切减压植骨融合内固定术54例;年龄44～75岁，平均57.1岁。B组颈椎后路单开门椎管扩大成型术33例;年龄41～73岁，平均61岁。C组颈椎后前路联合手术24例;年龄48～78岁，平均62岁。依据随访结果，比较术前、术后随访时JOA评分，颈椎弧度，进行分析研究。[结果]患者定期随访，时间3个月～5年，平

2、均2年，三组患者术后3、6、12个月及最后一次随访JOA评分与术前比较，差异有统计学意义(P<0.05)，各组间比较差异无统计学意义(P>0.05)。颈椎D值术后即刻与半年、末次随访时A、C两组组间无统计学差异(P值分别为P=0.434，P=0.492，P=0.569)，B组与另两组均有统计学差异(P均<0.05)。[结论]脊髓型颈椎病根据受压部位、病变范围选用不同的三种手术方式均能达到有效的治疗。前路和后前路联合手术能较好的恢复和维持颈椎生理弧度;后路术后颈椎弧度部分丢失。【关键词】颈椎病;手术方法;临床疗效　　Abstract:[O

3、bjective]Toexplorethetherapeuticeffect11ofthreesurgicalprocedures(anteriorapproach,posteriorapproachandposterior-anteriorapproach)forcervicalspondyloticmyelopathy(CSM).[Methods]Atotalof111patientswithcervicalspondyloticmyelopathytreatedwiththreesurgicalproceduresfromJune2002toDec

4、ember2007wereretrospectivelyanalyzed.GroupA(anteriorapproach)comprised54patientswithameanageof57.1years(ranged,44～75years).GroupB(posteriorapproach,Laminoplasty)comprised33patientswithameanageof61years(ranged,41～73years).GroupC(posterior-anteriorapproach)comprised24patientswitham

5、eanageof62years(ranged,48-78years).Allpatientswerefollowed-up,neuralfunctionandcervicalsagittalalignmentwererecorded.AccordingtoJOAscore,preoperativeandpostoperativefollow-upscoreswerecompared,improvementrateswerecalculated,respectively.[Results]Patientswerefollowedupfor3monthsto

6、5yearswithanaverageof2years.JOAscoresofthethreegroupsat3,6,12monthsandatthelastfollow-upafteroperationwerecomparedwiththoseofpreoperation(P<0.05).Therewasnosignificantdifferenceamongthethreegroups(P>0.05).Cervicalsagittalalignment(Dnumericalvalue)hadnostatisticaldifferencea

7、tthepostoperativeandthefinalfollow-upbetweengroupAandgroupC(P=0.434,P=0.492,11P=0.569).TherewassignificantdifferencebetweengroupBandgroupA/C(P<0.05).[Conclusion]Similarneurologicalimprovementwasobtainedbyanterior,posteriororanterior-posterioraproachforCSM.Anterioroperationanda

8、nterior-posterioroperationarehelpfultore