选择性减压植骨融合内固定联合介入治疗多节段颈椎间盘突出症的临床疗效观察

目的：探讨选择性经前路颈椎间盘切除减压、植骨融合内固定联合临近节段射频消融、臭氧盘内注射微创介入治疗多节段颈椎间盘突出症的临床疗效。方法2010-01-2011-12我院采用选择性减压植骨融合内固定联合微创介入治疗多节段颈椎间盘突出症15例，通过术前查体结合影像学资料确定主次要病变节段，选择性经前路切除主要病变节段椎间盘、椎体次全切除、椎间植骨或钛网植骨融合、钛板内固定术，术中同时对次要病变节段的颈椎间盘行射频消融、臭氧盘内注射等微创介入术。采用JOA评分和贾连顺评定法进行临床疗效评定。结果至末次随访JOA评分为（15.60±0.82）分，与术前比较差异有统计学意义（P〈0.05）。结论选择性减压植骨融合内固定联合微创介入是治疗多节段颈椎间盘突出症的确实有效的术式，中短期随访临床疗效显著。

Clinical effect of selective anterior cervical decompression and bone graft fusion combined with radiofrequency ablation and ozone injection in the treatment of multi-segment cervical disc herniation

Objective To evaluate the clinical effect of selective anterior cervical decompression and bone graft fusion combined with radiofrequency ablation and ozone injection in the treatment of multi-segment cervical disc herniation. Methods A retrospective follow-up was made in 15 cases of multi-segment cervical disc herniation treated by selective anterior cervical decompression and bone graft fusion combined with radiofrequency ablation and ozone injection in our hospital from January 2010 to December 2011. The primary and secondary pathological changes section were de-termined by preoperative examination combined with imaging data. To the primary changes section, selectivity by segmental anterior resection of total excision of the intervertebral disc,vertebral body and intervertebral bone graft or titanium net bone graft fusion and titanium plate fixation was used. Radiofrequency ablation and ozone injection was used to the secondary pathological changes section during operation. The pre-and postoperation conditions were evaluated by JOA scores. Results Pre-operative JOA score （7.80 ＆#177;1.50） points rose to （15.60±0.82） at the end of the follow-up time. Compared with preoperation, the difference was statistically significant （P〈0.05）. Conclusion Treatment of multi-segment cervical disc herniation by selective anterior cervical decompression and bone graft fusion combined with radiofrequency ablation and ozone injection is effective, and the medium-term follow-up clinical curative effect is distinct.