发育性颈椎管狭窄合并脊髓型颈椎病的手术治疗

目的探讨发育性颈椎管狭窄合并颈椎病的安全、有效、合理的治疗方法.方法回顾性分析并对109例发育性颈椎管狭窄合并脊髓型颈椎病的治疗进行总结,其中采用Cloward环锯法手术20例,采用颈椎体次全切除治疗62例,采用单开门颈椎管扩大成形术27例.前路手术同期均采取自体髂骨植骨融合.结果 109例中95例获12～76个月的随访,平均随访36个月,优良率81.1%,改善率3.7%～84%,平均73.4%,无脊髓、神经根或椎动脉损伤等并发症的发生.结论对于发育性颈椎管狭窄合并脊髓型颈椎病前路、后路各种术式有着各自不同的适应证,选择合理的治疗手段十分重要.

Surgical treatment for developmental cervical stenosis accompanied with cervical spondylotic myelopathy

Objective To investigate an effective and safe surgical methods for the treatment of developmental cervical stenosis accompanied with cervical spondylotic myelopathy Methods 109 cases of developmental cervical stenosis accompanied with cervical spondylosis myelopathy were reviewed and analyzed.20 cases were operated with Cloward method,62 cases with anterior subtotal veterbrectomy and 27 cases with the single-open-door cervical laminoplasty.Anterior fusion with grafting was done in all these cases.Results 95 cases were followed up from 12 to 76 months,with an average of 36 months.These cases were evaluated using the scoring system of the Japanese Orthopedics Association(JOA score).The excellent and good rate was 81.1%,the fair rate was 73.4%.No spinal cord injury,no nerve root injury,no veterbral artery injury were observed.Conclusion Both anterior and posterior surgical procedures are safe and effective methods for the treatment of developmental cervical stenosis accompanied with cervical spondylotic myelopathy.It is important for clinician to select a perfect indication.