手术治疗颈脊髓受压型疾病65例分析

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1、2010年6月




首都医科大学学报


Jun.2010第31卷
第3期



JournalofCapitalMedicalUniversityVo.l31
No.3[do:i10.3969/j.issn.1006
7795.2010.03.029]临床研究手术治疗颈脊髓受压型疾病65例分析1*23曹国栋
刘
波
侯冠华(1.北京市延庆县医院骨科;2.北京积水潭医院脊柱外科;3.山东銘业公司医院骨科)摘要!
目的
探讨颈脊髓受压型疾病的手术治疗方法。方法
对北京市延庆县医院骨科自2003年8月至2

2、008年11月收治的30例颈脊髓受压型病人及北京积水潭医院脊柱外科2008年12月至2009年9月收治的35例颈脊髓受压型患者行不同术式的手术治疗:颈前路减压30例,颈后路减压30例,前后路一期联合手术5例。按JOA评价临床疗效。结果
65例患者均得到9个月至5年门诊或电话随访,均获得满意疗效。结论
伴有发育性颈椎管狭窄者、颈椎后纵韧带骨化症(ossificationofposteriorlongitudinalligament,OPLL)者、退变性椎管狭窄者,选择颈后路椎管扩大成形术;1~2个椎间盘突出者选

3、择颈前路减压植骨融合钛板内固定术或行颈椎人工间盘置换术;椎管狭窄合并椎间盘突出较大脊髓前后受压者,可选择一期前后路联合手术。关键词!
颈脊髓受压;椎管狭窄;颈后路;颈前路;前后路联合+中图分类号!
R681.53SurgicalTreatmentofCervicalSpinalCordCompressiveDisordersin65Cases1*23CAOGuo
dong,LIUbo,HOUGuan
hua(1.DepartmentofOrthopedics,BeijingYanqingHospital;2.

4、DepartmentofOrthopedics,BeijingJishuitanHospital;3.DepartmentofOrthopedics,MingyeCorporationHospitalofShandongProvince)ABSTRACT!
Objective
Toexploresurgicaltreatmentofthecervicalspinalcordcompression.Methods
FromAugust2003toNovember2008,30casesofcervicalspi

5、nalcordcompressionweretreatedinBeijingYanqingHospitalandfromDecember2008toSeptember2009,35casesofcervicalspinalcordcompressionweretreatedinBeijingJishuitanHospitalwithdifferentkindofsurgicaltreatment.Allthepatientswerefollowedup.Results
Thirtycasesreceiveda

6、nteriordecompression,another30casesreceivedposteriordecompressionand5casesreceivedanteriorandposteriorapproachstage1combinedsurgery.The65patientswerefollowedupfor9monthsto5years(average3.3years)inoutpatientdepartmentorbytelephone.AccordingtotheJOA,allthepat

7、ientshadsatisfactoryoutcome.Conclusion
Posteriorspinalcanalexpansionangioplastyissuitablefordevelopmentalcervicalcanalstenosis,ossificationofposteriorlongitudinalligament(OPLL)anddegenerativespinalstenosis.Anteriorcervicaldecompressionandbonegraftfusionwith

8、titaniumplatefixationorcervicalartificialdiscreplacementaresuitableforone
two
dischernia.Theanteriorapproachandposteriorapproachisselectedforspinalstenosiscombinedwithspinecordcompressedfromfrontandrea