颈前路多节段减压重建术后生理弧度的前瞻性研究

目的：研究颈椎前路多节段减压后不同手术方法对颈椎结构的远期影响。方法：采用前瞻性研究，选取４９例随机分为２ 组。对照组在牵伸状态下植入３ 面皮质骨；试验组在用颈椎撑开器牵开椎间隙，植入自体骨后用前路钢板内固定。测量手术节段椎间高度及生理弧度。结果：Ｘ 线测量显示，试验组术后１ 周生理弧度明显增加，１ 月后生理弧度继续增加；其椎间高度较术前增加６ ｍ ｍ 以上，随访１ 年内椎间高度无明显改变。对照组术后１ 周生理弧度也有增加，但增加值明显低于试验组；术后１ ～３ 月生理弧度逐渐回复至术前水平。结论：颈椎前路牵开植骨加钢板内固定能有效地增加并维持颈椎椎间隙高度。

A Prospective Study of Cervical Spine after Multiple Segmental Anterior Decom pression and Fusion

Objective :To study the long term effect of anterior decom pression and fusion with different surgical therapy on cervical spinal structure .Methods :A prospective study were carried out and 49 cases of cervical spondylotic m yelopathy were in volved in thisinvestigation ,they were divided into two groups .The patientsin control group received autogenous bone graftfro m iliac for inter vertebrd fusion after anterior m ultiple cervical deco mpression .The patients as test group ,however ,received bone graft after the interbody space were distracted with a special device and follo wed with a cervical plate internal fixation .The in terbody space and curve of cervicalspine were measured postoperatively .Results :Postoperative X ray m easurement revealed that the cervical spinallordosis in the test group were increased .Its interbody space height of fusion segm ents were increased and maintain no change one year later .Though the interbody space heightin control group were increased 1 week postoperatively ,it returned to or lo wer than the preoperative levelthree m onthslater and the cervical spinallordosis returned to the previous level either .Conclusion :Anterior m ultiple segm ental cervical decom pression and interbody fusion with anterior plate internalfixation is an effective method to increase and to maintain the cervicalinterveterbral space height .