神经根型颈椎病的手术治疗

目的 总结神经根型颈椎病的手术治疗方法和疗效。 方法 回顾性分析153例神经根型颈椎病的手术经验,所有患者均经前路行手术治疗,切除病变间隙的椎间盘、增生骨赘及后纵韧带,取自体髂骨或融合器行椎间融合,钛板固定。 结果 患者手术时间30~90min,出血量10~100ml,术后随访时间9~72个月,平均随访时间14.3个月;量化疼痛与麻木程度,术前4~5分,术后迅速下降到0~2分,最终下降到0~1分,疼痛完全缓解,椎间骨性融合。 结论 前路手术治疗神经根型颈椎病,具有入路简单、出血少的特点,并且对脊髓与神经根前方的椎间盘和骨赘切除彻底,疗效确切,可避免保守治疗长期反复发作的缺点,比后路手术更安全、更有效。

Anterior Cervical Surgery for Cervical Spondylotic Radiculopathy

Objective To analyze the surgical techniques and outcomes of cervical spondylotic radiculopathy. Methods Totally 153 patients'data with cervical spondylotic radiculopathy unergoing surgery were collected and analyzed retrospectively. All patients received anterior cervical diskectomy, and excision of the intervertebral disc, osteophyte and post longitudinal ligaments. All patients underwent auto iliac graft implant or fusion cage and titanium plate fixation. Results Surgery time was 30 to 90 minutes. The amount of intraoperative bleeding was 10ml to 100ml.The median follow-up period was 14.3 months (9-72 months) after surgery. The degree of pain and numbness was quantified. It was 4 to 5 points before surgery, but dropped down to 0 to 2 points after surgery, finally to 0 to 1 point, with complete relief of pain and bone fusion of Interbody. Conclusion Anterior cervical surgery is effective for cervical spondylotic radiculopathy, with advantage of simple approach and less bleeding. Besides, the intervertebral disc and osteophytes in front of the spinal cord and nerve roots could be completely resected, avoiding repeatedly recurrence after conservative treatment, which is also more safe and effective than posterior surgery.