脊髓型颈椎病术式选择及疗效相关因素的研究

目的探讨脊髓型颈椎病手术方式选择的原则及影响手术疗效的相关因素。方法收治脊髓型颈椎病患者32例,前路手术18例,后路手术12例,前后路联合手术2例。将患者年龄、病程、脊髓最大压迫处矢状径、手术方式及椎间高度增加值与疗效进行统计学分析。结果患者年龄、病程、脊髓最大压迫处矢状径及椎间高度增加值影响术后疗效,手术入路及手术方式不影响疗效。结论脊髓型颈椎病一经确诊,选择合适的手术方式可获得良好的疗效,关键在于切除引起症状体征的、经影像学检查证实压迫脊髓的病变,同时要有效重建颈椎的稳定性。

The Choice of Operative Method and the Analysis of Correlative Factors for Cervical Spondylotic Myelopathy

Objective To explore the choice of operative method and the correlative factors of cervical spondylotic myelopathy. Methods 32 case of cervical spondylotic myelopathy treated by operation were reviewed, 18 with antirior decompression, 12 with open door laminoplasty, 2 with back and forth decompression at the same time. The treatment results and common influencing factors were analyzed. Results The treatment results had relationship to disease course, patient s age, compresed degree of myelos, and increased height of intervertebral disc involved. But the results had no relationship to operative approach and methods. Conclusion The operation should be performed as soon as possible when cervical spondylotic myelopathy is diagnosed exactly. The satisfactory result will be achieved by surgery on exactly decompression of compresed myelos and stable reconstruction of cervical spine.