交感型颈椎病的手术治疗(附18例报告)

目的　探讨颈椎不稳在交感型颈椎病发病机制中的作用及其手术治疗。方法　回顾 1995～ 2 0 0 2年 18例经保守治疗无效的严重症状交感型颈椎病患者的手术治疗体会 ,采用前、后路颈椎手术 ,部分使用内固定物。结果　 18例均有颈椎不稳 ,14例行颈前路间盘切除自体骼骨植骨融合 ,结合前路钢板固定 8例 ,后路单开门椎管扩大成形 ,不稳节段门轴、小关节植骨融合 4例 ,配合侧块钢板固定 3例。术后随访 8-70个月 ,平均 3 0个月 ,均获得融合 ,治疗有效率 88.9%。结论　颈椎不稳在交感型颈椎病的发病中起重要作用 ,以稳定和减压为目的前后路颈椎手术均可获得满意疗效

The surgical treatment for sympathetic cervical spondylosis

Objective To investigate the role of cervical instability in the etiology of the sympathetic cervical spondylosis and surgical treatment of this condition.Methods 18 patients sufferring from severely sympathetic cervical spondylosis conservatively treated inefficent,underwent operations through an anterior or posterior approaches.Lateral views in flexion and extension of cervical radiography were took to evaluate cervical instability.For cervical stabilization and decompression,an anterior discectomy and fusion was performed in 14 patients,or with subtotal-vertebrectomy when required,and posterior opendoor laminoplasty and fusion at unstable segments in 4 patients with cervical canal stenosis.Both anterior and posterior approach should use internal instrumentation as needed.Results After operation,patients were followed for 8 to 70 months,average 30 months.The effective rate is 88.9%.Conclusions Cervical instability is an important factor in the etiology of sympathetic spondylosis.Both approaches are effective to treat sympathetic cervical spondylosis.