前路“杂交式”减压治疗多节段颈椎病：可有效改善颈椎生理弯曲度及椎间高度

背景：单节段或双节段颈椎病患者通常采用颈椎前路减压内固定,但对于多节段颈椎病手术方式的选择一直存在争议。目的：探讨前路＂杂交式＂减压即单椎体次全切联合椎间盘切除治疗多节段颈椎病的方法及临床效果。方法：回顾性分析30例多节段颈椎病患者资料,均选择前路＂杂交式＂减压、自体髂骨植骨及ZEPHIR钢板内固定。观察治疗后患者神经功能评分、植骨融合率、颈椎生理曲度和椎间高度变化及并发症情况。结果与结论：随访12～72个月,平均36个月。颈椎生理曲度及椎间高度较治疗前明显改善,受压节段脊髓膨隆良好。钢板及螺钉无松动、断裂或移位。治疗后6个月植骨均融合,12个月JOA评分明显提高,改善率优10例,良16例,可4例,优良率86.7%。说明采用前路＂杂交式＂减压治疗多节段颈椎病,减压直接彻底并能尽量保留颈椎结构,增加植骨融合率,有效改善颈椎生理曲度和椎间高度。

Anterior hybrid decompression efficiently improves the cervical physiological curvature and intervertebral height in treatment of multilevel cervical spondylosis

BACKGROUND：Patients with cervical spondylosis of single or double segments are mainly treated with anterior decompression and internal fixation.The therapy selection of multilevel cervical spondylosis is still in dispute.OBJECTIVE：To discuss the surgical method and clinical effect of anterior hybrid decompression technique（subtotal single vertebrectomy combined with intervertebral discectomy） in treatment of multilevel cervical spondylosis.METHODS：Retrospective analysis was performed in 30 patients with multilevel cervical spondylosis.All the patients received anterior hybrid decompression,autogenous iliac bone grafting or ZEPHIR plate internal fixation.The neurological function scores,fusion rates,cervical physiological curvature and intervertebral height,and complications of patients were analyzed after treatment.RESULTS AND CONCLUSION：The patients were followed up for 12-72 months,with an average of 36 months.The cervical physiological curvature and the intervertebral height were significantly improved after surgery.The spinal cord of oppressed segments was well bulged.Loosening,fracture and displacement of the plates and screws were not found during the follow-up.The postoperative fusion rate was 100% at 6 months.The Japanese Orthopaedic Association scores were obviously improved after 12 months of follow-up.The improvement rate outcome showed excellent in 10 cases,good in 16 cases,fair in 4 cases,and the good rate was 86.7%.The anterior hybrid decompression can retain normal structure of the cervical spine through decompression,increase the fusion rate and efficiently improve the cervical physiological curvature and intervertebral height,thus it can be used in treatment of multilevel cervical spondylosis.