脊髓型颈椎病前后路手术疗效及随访结果

目的　探讨脊髓型颈椎病患者前后路手术治疗的近期和远期效果。方法　 2 76例脊髓型颈椎病患者 ,196例施行颈后路主椎板扩大成形术 ,80例施行颈前路椎间盘切除减压 +植骨融合术 ,其中 5 0例加带锁钢板内固定。总结颈椎前后路手术的治疗效果及 2年以上的随访结果。结果　颈前路手术改善率 82 .8%。颈后路手术改善率 84 .4 % ,随访 6 5例 ,未行钢板固定前 2例植骨块脱落 ,颈椎轻度反弓 ,1例骨不连 ,余 6 2例骨性融合 ,融合率 96 .2 %。颈后路 196例 ,随访 15 6例 ,88例出现不同程度的轴性症状 ,12例颈僵 ,5 6例颈椎曲度变直。结论　对短阶段颈椎间盘突出 (1～ 3)或颈椎失稳引起的颈椎病 ,宜选择创伤小 ,并发症少 ,且术后功能恢复好而持久的颈前路术式。

Effect of treatment and followed-up in patients with cervical spondylotic myelopathy operated by anterior or posterior approach

Objective To explore the short-term and long-term results of treatment in patientswith cervical spondylotic myelopathy (CSM) operated by anterior or posterior approach.Method Two hundred and seventy six CSM patients treated with cervical anterior or posterior approach.The therapeutic effect and a 2 years followed-up results were retrospective analysed.Results Among of 276 cases,196 patients were treated with canal enlarge arthroplasty by cervrical posterior approach,and other 80 cases were treated with cervical diss abscission-decompression and bone graft placed fussion by cervical anterior.The 50 cases were fixed by anterior cervical spine locking plate and screws.Accroding to JoA' standerd of grading 17,the average point was 6.5 in cervical anterior approach before oppration and it was 15.2 after operation,the increased rate was 82.8%.The posterior approach the point was 6.7 before operation,and it was 15.4 after operation, the increased rate was 84.4%.Conclusion The anterior approach in CSM patients with cervical spondylotic myelopathy for cervical instability and short segement of the cervical intervertebral disc possesses less trauma and complications,and the post-operation recovery was good and lasting.