椎间盘切除__(期刊论文)

颈前路显微外科手术治疗脊髓型颈椎病

http://www.100md.com 《中国矫形外科杂志》 2006年第3期

椎间盘切除,,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,1资料与方法,2结果,3讨论,参考文献：

     (广西壮族自治区人民医院，南宁市530021；Northern General Hospital,The University of Sheffield,Sheffield,S5 7AU,UK)

    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182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(825±36)%，优良率737%。融合节段后突角度平均改善63°，有统计学意义(P<001)。[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)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

    Anterior microsurgerical decompression and intervertebral fusion with plating for cervical spondylitic myelopathy∥

    Yin Dong,NeilChiverton

    Guangxi Zhuang Autonomous Region Hospital,Nanning,530021

    Abstract：[Objective]To introduce and evaluate the efficacy of anterior microsurgical decompression and titanium cage implants fusion with anterior plating in cervical spondylitic myelopathy[Method]A retrospective analysis was done in 61 consecutive patients who underwent anterior microsurgical decompression followed by intervertebral fusion by using a titanium cage packed with autogenous cancellous bone graft and an anterior cervical platingThe bony endplates were preserved to prevent cage subsidenceFortyfour cases were one level and 17 cases were two levelsThe followup period ranged from 12 to 36 months,with an average followup period of 182 monthsFusion was judged by the less than 2 mm motion between the spinous processes of the surgically managed levels on flexionextension lateral radiographsThe segmental kyphosis preoperatively and lordosis postoperatively was measured with Cobbs methodPre and postoperative neurological status were assessed by using the cervical myelopathy scoring system of the Japanese Orthopedic Association[Result]No patient experienced severe complicationsThere was radiographic evidence of fusion in all 61 patientsImprovement ratio of neurological status was (825±36)%Excellent and good rate was 737%Segmental sagittal lordosis was significantly improved[Conclusion]Anterior cervical microsurgical decompresssion is a safe and effective treatment option in wellselected patients with cervical spondylitic myelopathy,resulting in a significant improvement of neurological functionTitanium cage interbody fusion with concomitant use of anterior plating provides immediate biomechanical stability,can successfully restore and maintain posterior interbody height and cervical lordosis to ensure satisfactory longtime outcomes ......

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