颈胸段脊柱病变的手术入路选择

目的]探讨不同手术入路治疗颈胸段脊柱病变的疗效。方法]12005年1月至2008年10月收治的36例颈胸段脊柱病变患者，采用不同手术入路治疗。肿瘤13例，结核20例，椎间盘病变3例。术前Frankel分级：A级2例，B级8例，C级15例，D级3例，E级8例。结果]随访3～47个月，术后3～8个月所有患者植骨部位均达到骨性愈合。术后Frankel分级：A级1例，B级2例，C级2例，D级15例，E级16例，平均改善1．1级。2例肿瘤转移的患者分别于术后11个月、17个月死亡。结论]颈胸交界区域脊柱解剖结构复杂，应根据病变的性质、位置、范围、影像学改变等选择恰当的手术方式。

Surgical Approach Choice in the Treatment for Cervicothoracic Spinal Lesion

Objective]To investigate the curative effect of different surgical approaches in the treatment for cervicothoracic spinal lesion. Methods] Thirty six patients with cervicothoracic spinal lesion were admitted to our hospital from Jan. 2005 to Oct. 2008, and the patients were treated with different surgical approa- ches. Among the patients, 13 had tumor, 20 had tuberculosis and 3 had vertebral disc pathological change. The classification of Frankel was as follows： 2 at grade A,8 at grade B, 15 at grade C, 3 at grade D and 8 at grade E. Results] Patients were followed up for 3~47 months. All the patients achieved bony fusion, and bony fusion time was 3 to 8 months. The classification of Frankel post-operation was as follows： 1 at grade A, 2 at grade B, 2 at grade C, 15 at grade D, 16 at grade E, and improved 1.1 grade in mean. Two patients with cancer metastasis died in 11 months and 17 months after operation. Conclusion] Cervicothoracic spinal anato- my is complicated, so appropriate surgical approach should be chosen according to the character, the position, the range and image change of cervicothoracic spinal lesion.