双钢板在颈前路手术中的应用

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1、双钢板在颈前路手术中的应用作者：张海龙，傅强，葛星野，赵鑫，陈元贵，尚保华，侯铁【摘要】［目的］探讨“跳跃型”多节段脊髓型颈椎病行颈前路双钢板固定的应用价值。［方法］本院XX年7月〜)(X年7月对21例“跳跃型”多节段脊髓型颈椎病及7例脊髓型颈椎病再次手术患者行颈前路单间隙切除+单间隙切除+自体髂骨植骨、双钢板内固定术。术后6、9、12个月随访摄片，对其症状缓解、植骨融合、内固定及并发症情况进行观察。［结果］所有患者获得16〜32个月的随访。根据JOA评分，患者平均改善率为％;术后6个月融合率为％，9个月融合率为％，术后12个月融

2、合率为93%;无患者死亡，供骨区并发症6例。此术式手术适应证：适用于病理压迫位于脊髓前方的患者，包括中央型、广基的椎间盘突出、邻近或位于椎间盘的较大桥接骨赘，尤其适用于非颈椎前凸的“跳跃型”多节段脊髓型颈椎病患者。并发症：通常与解剖过程中软组织的损伤及神经受损有关，另外，亦可发生远期内固定与融合失败。［结论］“跳跃型”多节段脊髓型领椎病及脊髓型颈椎病再次手术患者行颈前路双钢板固定，可获得较满意的临床疗效。可以重建椎管容积以及椎间孔的高度，有效解除脊髓前方所受的压迫；对于伴有颈椎后凸畸形的颈椎病患者，既能前路减压又能重建颈椎生理前凸

3、。【关键词】脊髓型颈椎病；前路手术；带锁钢板Abstract:[Objective]Toinvestigatethevalueofdoubleplatesintheanteriorapproachforthetreatmentofjumpingmu11ilevelCSM.[Method]FromJu1yXXtoJu1yXX,21casesofjumpingmultilevelCSMand7casesofCSMwereoperatedwithsingleleveldiscectomy/anteriorcorpectomyandsel

4、f-i1iacbonegraftandfixationbydoublethe6,9,12monthfollow-up,bonefusionwereassessedandneurologicalfunction、complicationswererecorded.[Result]Allpatientswerefollowedupforl6〜32months(24monthsonaverage).BasedonJOAevaluation,theaverageimprovingratewas%.And%fusionwasachieved

5、at6months,thefusionratereached%and93%at9andl2monthsaccordingly.Therewere6caseswithcomplicationsinthedonorsiteofofthisapproachtheeompressingpathologywaslocatedanteriortothespinalincludedcentral,broad-baseddischerniationsandlargebridgingosteophytesatoradjacenttothelevel

6、ofthediscitwasespeciallyindicatedforpatientswithjumpingmultilevelCSMwhodidnothavealordoticcomplicationsoccurringwiththisapproachcopinetohelprestorealordoticcurvature.uldberelatedtoinjueduringdissectionoaddition,postoperarefailurecouldoccur.leleveldiscectomy/andself-il

7、iacbonegoubleplatesisaneffhejumpingmultileveofthespinalcanalanrmaldimensionstodehecasesofjumpingmueakyphoticdeformitdecompressionandreriestothesofttissurtotheneurologicaltivefusionorhardwa[Conclusion]Singanteriorcorpectomyraftandfixationbydectivetreatmenttotlallowsres

8、torationdneuralforamentonocompressthespinaltltilevelCSMthathavy,itallowsanteriorconstructionofthesKeywords:cervicalspondylot