脊髓型颈椎病两种前路手术方式分析

目的：分析脊髓型颈椎病两种前路减压融合术的疗效。方法：对70例脊髓型颈椎病患者行前路减压,分别采取单纯自体髂骨植骨（A组）和钛网自体椎骨植骨加Zephir钢板内固定（B组）。对术后脊髓功能改善率、骨融合时间、并发症等进行比较。结果：两组单节段术后脊髓功能改善率的差异无统计学意义（P〉0.05）,骨融合时间和并发症发生率的差异均有统计学意义（P〈0.05）。两组双节段术后脊髓功能改善率的差异无统计学意义（P〉0.05）,骨融合时间和并发症发生率的差异均有统计学意义（P〈0.05）。结论：单纯自体髂骨植骨方法简单,但植骨不融合、塌陷等并发症较多。钛网自体椎骨植骨加Zephir钢板固定牢固,符合颈椎生物力学特性,术后椎间骨性融合时间短,并发症少,是一种治疗脊髓型颈椎病的理想手术方式。

Analysis of Effect of Two Anterior Approaches of Surgery on Cervical Spondylotic Myelopathy

Objective To analyze the effect of two kinds of surgical approach for anterior decompression on cervical spondylotic myelopathy（CSM）. Methods Seventy cases of CSM were treated with anterior decompression and bone graft, 24 of them were treated with iliae autograft （group A） and the others were treated with graft of titanium cage filled with autogenous spondylous and stabilized with Zephir plate （group B）. The improvement rate of myelonic function, time of vertebral fusion and complication of the operation were compared between the two groups during follow - ups. Results There were no significant difference in the improvement rates of myelonic function between two single segment groups （P 〉 0.05）. However, significant differences between two mono- segment groups could be observed at the time of verte- bral fusion and complications of the operation （ P 〈 0.05）. The same results could be obtained in two ambi - segment groups. ConclusionIliac autograft is a simple method for CSM. However, it leads to complications such as nonfusion and collapse. Graft of titanium cage filled with autogenous spondylous and fixation with Zephir plate is an ideal surgical method for CSM, as with biomechanical characteristics and short time of vertebral fusion and less morbidity.