颈椎病前路手术方案的选择与预后的关系

目的探讨脊髓型颈椎病前路手术方式的选择及相关因素对预后的影响。方法回顾分析84例临床资料,分别为A组:M etrx椎间盘镜下髓核摘除植骨融合术;B组:椎体次全切除减压植骨术;C组:椎体次全切除减压植骨并钢板、钛网内固定术。结果随访各组病例对于各术式适应证均取得满意疗效,各方案无明显优劣。对于椎体次全切除未予钢板固定者,术后12个月改善率较6个月时有显著性下降(P<0.05);给予钢板固定的椎体次全切除者,12个月改善率较6个月时无明显下降。结论影响预后的因素较多,正确应用经颈前路各术式均能达到有效减压的目的。辅以前路钢板内固定将使融合节段更加稳定,有助于改善脊髓型颈椎病的远期疗效。

The Relationship between the Different Anterior Approach Surgical Schemes in the Treatment of Cervical Spondylotic Myelopathy and Its Prognosis

Objective To investigate the effect of surgical schemes of anterior approach and correlative factors for the treatment of cervical spondylosis myelopathy(CSM) on its prognosis.Methods 84 cases of CSM treated by anterior approach decompression with different anterior approach surgical schemes were reviewed.group A: anterior cervical discectomy and interbody fusion using Metrx endoscopic discectomy system;group B: subtotal resection of cervical vertebrae for decompression and bone allograft or autograft for cervical fusion;group C: subtotal resection of cervical vertebrae for decompression and bony implant plus Codman locking plate.Results All surgical schemes of anterior approach obtained satisfied curative effects and the surgical schemes had no significant differences.At 12 months after operation,the amelioration in the group B decreased obviously(P<0.05),but it was not declined in the group C.Conclusion The effects of treatment had many correlative factors.The satisfactory result will be achieved by each surgical schemes of anterior approach on adaptive patients.Using internal fixation of locking plate system could improve the stabilization of cervical fusion and ameliorate the long period curative effect.