多节段前路减压植骨融合并钢板内固定术治疗脊髓型颈椎病

目的 探讨多节段前路减压植骨融合钢板内固定术在脊髓型颈椎病中的应用价值。方法 38例脊髓型颈椎病患者，病变累及3个椎间隙者34例，4个椎间隙者4例。经颈前路椎体次全切除减压，取自体髂骨植骨融合，并行颈前路钢板固定。结果 术中硬膜撕裂2例，术后咽痛6例。38例随访平均22．5个月，植骨于术后12～28周骨性愈合。术后恢复之椎间高度未发生再丢失现象，颈椎生理曲度维持良好。螺钉松动、钢板翘起3例。无钢板、螺钉折断等并发症。JOA评分平均提高8．4分，手术有效率为94．7％，优良率为78．9％。结论 多节段前路减压植骨钢板内固定治疗脊髓型颈椎病能实现彻底减压，对脊髓功能恢复有重要意义。

Anterior multilevel decompression and autograft fusion with plate fixation for cervical spondylotic myelopathy

Objective] To analyze the practical value and efficacy of cervical anterior multilevel decompression and autograft interbody fusion with an additional plate fixation for cervical spondylotic myelopathy. Method] Thirty-eight patients with multilevel cervical spondylotic myelopathy treated by anterior multilevel decompression, interbody fusion, and plating were analysed retrospectively. The outcomes was assessed by clinical criteria and radiographs of the cervical spine. Result] The patients were followed up for 22.5 months in average. All fusion was determined at 12~18 weeks. The JOA scores were improved 8.4 and the rate of excellent and good results was 78.9%. Conclusion] Anterior multilevel decompression and autograft fusion with plate fixation for cervical spondylotic myelopathy is an ideal procedure for cervical spondylotic myelopathy. It appears to yield reliable stability after complete decompression which can promote the bone graft fusion and improve the spinal cord function consequently.