采用颈前路减压内固定治疗脊髓型颈椎病53例疗效观察

目的探讨脊髓型颈椎病患者的治疗方法与疗效分析。方法对本院53例脊髓型颈椎病患者均采用颈前路减压内固定法进行治疗,对患者术后的神经功能、临床功能、影像学情况进行评价、分析。结果 53例患者术中均无死亡。随访1-2年,平均(1.6±0.2)年,其中神经功能优27例(50.94%),良16例(30.19%),中7例(13.21%),无效3例(5.66%)。患者术前、术后JOA评分有显著差异性,P<0.05,有统计学意义。临床功能优33例(62.26%),良19例(35.85%),差1例(1.89%)。本组术后3-12个月常规行颈椎MRI检查,18例患者结果显示压迫因素解除。结论脊髓型颈椎病患者采用颈前路减压钛网植骨或植自体骼骨于颈前路带锁钢板内固定治疗,其疗效显著,方法稳定、支撑手术椎体节段与诱导成骨的特点,值得临床推广。

Clinical Observation of 53 CSM Patients Treated with Anterior Decompression and Internal Fixation

Objective To explore the method for treating cervical spondylotic myelopathy and analyze the therapeutic effect. Method 53 CSM patients of our hospital were treated by anterior decompression and internal fixation and then the postoperative neurologic function, clinical function and imaging condition were evaluated and analyzed. Results There was no death occurred during the surgery. Follow-up visit was conducted for 1 to 2 years, with the mean term of 1.6±0.2year. Of the 53 patients, there were 27 patients with excellent neurologic function （50.94%）, 16 with good function （30.19%）, 7 with medium function （13.21%）, and 3 with invalid function （5.66%）. For the JOA scores of patients before and after the surgery, there was significant difference, P〈0.05, and there was statistical significance. Besides, there were 33 patients with excellent clinical function （62.26%）, 19 with good function （35.85%）, and 1 with poor function （1.89%）. This group of patients was given cervical MR] examination 3 to 12 months later after the surgery, and 18 patients had the results indicating that the oppression factors bad been removed. Conclusions Treatment for CSM patients with anterior decompression and titanium mesh bone graft or autograft iliac bone graft in anterior cervical plate for internal fixation has the characteristics of obvious therapeutic effect, stable method, and supporting vertebral segments and inducing osteogenesis, being worth spreading in clinical practice.