改良颈椎椎体次全切除术临床疗效随访

采用改良式颈椎椎体次全切除术治疗６６例多节段脊髓型或脊髓神经根混合型颈椎病。手术有效率为９５．５％（６３例），优良率为８４．８％（５６例），无手术死亡或重残发生。该术式的优点是手术野较大，脊髓损伤机会少，能同时直接去除椎间盘水平和椎体后方的脊髓压迫，且可避免椎体切除过多和脊髓减压不充分，镶嵌植骨和术后颈胸口膏围领外固定能防止植骨块脱出和确保植骨融合。最为适宜２￣４个节段的脊髓型或脊髓神经根混合型颈

FOLLOW UP SURVEY OF THE CURATIVE EFFECT OF IMPROVED CERVICAL SUBTOTAL VERTEBRECTOMY

Improved subtotal vertebrectomy was performed in 66 patients with multi segmental cervical spondylotic myelopathy or myeloradiculopathy.63 (95.5%) patients showed improvement and 56 (84.8%) showed remarkable improvement. No mortality and serious deterioration occurred in all patients. The advantages of improved subtotal vertebrectomy were:(1)less damage in the spinal cord due to a larger operative field; (2) the spinal cord decompression at the disc level and body level; (3) passible avoidance of over removed vertebral body and less enough decompression for the spinal cord; (4)prevention of bone graft from prolapsing by embedded bone graft and postoperative cervicothoracic plaster collar. The authors conclude that improved subtotal vertebrectomy is fittest for 2 4 segmental cervical spondylotic myelopathy or myeloradiculopathy.