颈椎病前路减压融合术疗效分析

目的 分析颈椎病前路减压融合不同术式的疗效,探讨影响颈椎前路手术的技术因素.方法 自1990年1月～2006年3月,笔者共行颈椎前路手术1843例,其中具有完整资料352例,随访明间最短6个月,最长12年,平均5.1年,根据不同手术方法以及是否保留后纵韧带(PLL)分组按照日本骨科协会(JOA)评分标准进行疗效评价.采用SPSS 10.0软件对各种术式疗效,脊髓太后矢状经增加值及融合率进行比较.结果 同一术式中保留PLL组与切除PLL组疗效有显著异,保留PLL组与切除PLL组各组间不同术式疗效无显著性差异;同一术式中保留PLL组与切除PLL组与切除PLL组脊髓术后矢状径增加值有显著态及神经功能恢复;是否应用内固定及应用种类与临床疗效和融合率无明显关系.

Analysis of Effectiveness of Anterior Decompression and Fusion Procedures for Cervical Spondylosis

Objective To analyze the results of several cervical spine anterior decompression procedures for cervical spondylosis and to investigate the key points of these procedures.Methods From January 1990 to March 2006,1843 patients with cervical degenerative spondylosis were treated with anterior decompression and 352 were followed up for 6 months to12 years with an average of 5.1 years.These patients were divided into several groups according to different decompression procedures and whether the posterior longitudinal ligament(PLL)was resected.The Japanese Orthopedic Association(JOA)scoring system was used for evaluating clinical outcomes.Software SPSS 10.0 was used to process the follow up date of the curative effect,the fusion rate and the increment of sagittal diameter of spinal cord.Results In the same procedure,there was significant difference in curative effect between reservation and resection of posterior longitudinal ligament.There were no significant difference in the curative effect of several procedures between the PLL resection group and the PLL reservation group.There was significant difference in the increment of sagittal diameter of spinal cord between the PLL resection group and the PLL reservation group.There was no significant difference in the fusion rate of different procedures.Conclusion The decompression is more effective after resection of PLL,which is helpful for the restoration of spinal cord posture and recovery of neurological function.Whether internal fixation is used and which types of the fixators are not related to the curative effect and the fusion rate.