单节段人工椎间盘置换加短节段颈前路减压植骨融合术治疗多节段颈椎病

【目的】探讨单节段人工椎间盘置换加短节段颈前路减压植骨融合术治疗多节段颈椎病临床疗效。【方法】湖南省人民医院2007年2月至2011年3月收治的10例多节段颈椎病手术病例，均行单节段人工椎间盘置换加短节段颈前路减压植骨融合术，随访时间为12～15个月，平均随访13．5个月，均摄颈椎磁共振及术前、术后及末次随访时的颈椎正侧位及颈椎过伸过屈位X线片，观察植骨融合、内固定及人工椎间盘的情况，以JOA评分评价神经功能改善情况。【结果】所有病例内置物无松动、移位，植骨融合时间在3～6个月，平均3．7个月。置换间隙术前活动度为（11．8°±5．3°），术后1年时为（11．2°±5．8°），与术前比较无统计学差异（P〉0．05）。术前JOA评分平均为9．5分，术后6个月时平均为16．3分，平均改善率为90．7％。【结论】单节段人工椎间盘置换加短节段颈前路减压植骨融合术治疗多节段颈椎病近期疗效满意。

Single-segment Artificial Disc Replacement Combined with Short-segment Anterior Cervical Decompression, Autograft Bone Fusion for the Treatment of Multi-segment Cervical Spondylosis

Objective] To explore the clinical efficacy of single-segment cervical artificial disc replace- ment, short-segment anterior cervical decompression and autograft bone fusion for the treatment of multi-seg- ment cervical spondylosis. Methods]Ten patients with multi-segment cervical spondylosis operated in our hospital from Feb. 2007 to March 2011 were analyzed retrospectively. All patients underwent single-segment cervical artificial disc replacement, short-segment anterior cervical decompression and autograft bone fusion. The follow up time was 12-15 months（average 13.5 months）. Cervical MRI and X-ray films of cervical nor- real lateral position and hyperextension and hyperflexion position were performed before and after operation and at the last time of follow up. Bone fusion, internal fixation and artificial disc were observed. JOA score was used to evaluate the improvement of neurological function. Results] No loosening and displacement of im plants in all patients was observed. The bone fusion time was 3~6 months（mean 3.7 months）. Preoperative movement of interspace was （11.8°±5.3°） and postoperative movement of interspace at the first year was （11.2°±5.8°） , and there was no significant difference between before and after operation（ P〉0.05）. The average JOA scores before and 6 months after operation were 9.5 and 16.3, respectively. The mean improvement rate was 90.7 %. Conclusion] Single-segment cervical artificial disc replacement, short segment anterior cervical decompression and autograft bone fusion for the treatment of multi-segment cervical spondylosis has satisfactory effect.