颈椎后方入路手术对脊髓型颈椎病的治疗价值

目的探讨采用后方入路手术治疗脊髓型颈椎病的临床效果。方法回顾性分析2005年1月2009年1月采用后方入路手术治疗35例脊髓型颈椎病。其中，男21例，女14例；年龄34～72岁，平均565岁。发病节段：C3-C7 2例，C3-T1 4例，C3-C7 29例。本研究所有患者均先采用颈椎后方入路手术。依据JOA评分标准，观察并记录患者的神经功能恢复情况，术后随访时JOA评分，评价临床治疗效果。结果出院时JOA评分术前提高2～5分，优950．良8例，可14例，差4例，优良率为48．57％。术后全部得到随访6月至2年，JOA评分提高3～8分，优11例，良14例，可7例，差3例，优良率为71．43％。结论后路手术为脊髓型颈椎病手术治疗提供了一种比较安全、可靠的方法，可提高脊髓型颈椎病临床改善率，减少并发症发生。

Therapeutic value of posterior approach surgical treatment for cervical spondylotic myelopathy

Objective To study the therapeutic effects of posterior approach surgical treatment on cervical spondylotic myelopathy. Methods Thirty-five patients with cervical spondylotic myelopathy operated by posterior approach surgical treatment from Jan. 2005 to Jan. 2009 were analyzed retrospectively. There were 20 males and 12 females in this study with an average age of 56.5 years old （ranged from 34 to 72 years）. The invasional segments were C2-C7in 2 cases, C3-T1 in 4 cases, C3-C7 in 29 cases. All cases had the posterior cervical open-door laminoplasty decompression. All the cases were followed up after operation. Neural function was recorded according to JOA score, improvement rates were calculated respectively. Results After discharge, the scores of JOA increased 2-5 points compared with that before operation. The function of the neural function showed excellent in 9 cases, good in 8, fair in 14 and poor in 4. The good-excellent rate was 48.57%. All cases were regularly followed up. The average duration of follow-up was 13.5 months （ranged from 6 to 24 months）.The scores of JOA increased 3-8 points compared with that when discharged. The function of the neural function showed excellent in 11 cases, good in 14, fair in 7 and poor in 3. The good-excellent rate was 71.43%. Conclusion The posterior approach surgical treatment for cervical spondylotic myelopathy is able to raise the clinical improvement rate and to reduce the occurrence of the complications.