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1、XX大学毕业论文2014年6月25日三种手术方法治疗脊髓型颈椎病的临床疗效作者：刘艳兵，中勇，杨大龙，李志远，王林峰【摘要】［H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
2、，吋间3个月〜5年，平均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(P0.05),各组间比较差异无统计学意义(P0.05)。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杲(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床部位、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:[Objective]T
3、oexplorethetherapeuticeffectofthreesurgicalprocedures(anteriorapproach,posteriorapproachandposterior-anteriorapproach)forcervicalspondyloticmyelopathy(CSM).[Mcthods]Atotalof111patientswithcervicalspondyloticmyelopathytreatedwiththreesurgicalproceduresfromJune2002toDecember2007wereretros
4、pectivelyanalyzed.GroupA(anteriorapproach)comprised54patientswithameanageof57.1years(ranged,44〜75years).GroupB(posteriorapproach,Laminoplasty)comprised33patientswithameanageof61years(ranged,41〜73years).GroupC(posterior-anteriorapproach)comprised24patientswithameanageof62years(ranged,48-
5、78years).Allpatientswerefollowed-up,neuralfunctionandcervicalsagittalalignmentwererecorded.AccordingtoJOAscore,preoperativeandpostoperativefollow-upscoreswerecompared,improvementrateswerecalculated,respectively.[Results]Patientswerefollowedupfor3monthsto5yearswithanaverageof2years.JOAsc
6、oresofthethreegroupsat3,6,12monthsandatthelastfollow-upafteroperationwerecomparedwiththoseofprcopcration(P0.05).Therewasnosignificantdifferenceamongthethreegroups(P0.05).Cervicalsagittalalignment(Dnumericalvalue)hadnostatisticaldifferenceatthepostoperativeandthefinalfollow-upbetweengrou
7、pAandgroupC(P=0.434,P=0.492,P=0.569).TherewassignificantdifferencebetweengroupBandgroupA/C(P0.05).[Conclusion]Similarneurologicalimprovementwasobtainedbyanterior,posteriororanterior-posterioraproachforCSM・Anterioroperationandanterior-posterioroperationarehelpfultoresumeandmaint
