单节段神经根型颈椎病的手术疗效与术式选择

目的 探讨单节段神经根型颈椎病的外科手术疗效及术式选择。 方法 34例单节段神经根型颈椎病患者接受手术治疗，男26例，女8例，年龄36（22～58）岁，发病时间2.6个月（2天～6个月），　10例患者有明显的上肢肌萎缩及肌力减弱，MRI检查均为单节段颈椎间盘突出。术式选择：①前路椎间盘减压、植骨融合、内固定26例；②非融合技术8例，包括前路颈人工椎间盘置换术6例、后路局限性椎板部分开窗减压、突出髓核摘除2例。　结果　随访（1～6）年。术后症状显著好转，疼痛VAS评分自术前8.5±1.2，下降至术后3.1±0.5，10例肌萎缩及肌力减弱患者中7例全部恢复，3例部分改善。所有患者均对术后效果表示满意。 结论 前路减压融合或者非融合技术治疗单节段神经根型颈椎病，均效果良好，非融合技术具有良好应用前景。

Surgical treatment for single-level cervical spondylotic radiculopathy

Objective　To study the clinical efficacy of surgical treatment for single-level cervical spondylotic radiculopathy.　Methods　Thirty-four patients with single-level cervical spondylotic radiculopathy, including twenty-six males and eight females with average age of thirty-six years old ( 22 to 58 years), and ten of them with muscular atrophy and strength decrease of upper limb, received surgical treatment. Duration between onset of radicular pain and the surgery were two days to six months (mean 2.6 months). Single-level of cervical intervertebral disc herniation was determined by MR scan in all patients. Anterior cervical discectomy and fusion (ACDF) was carried out in 26 cases, and non-fusion procedures including cervical artificial disc replacement or posterior key-hole decompression in other eight cases.　Results　All patients were followed up about one to four years, with obvious decrease of radicular pain and numb after surgery. Post-operational VAS improved from 8.5±1.2 to 3.1±0.5. Seven of ten cases with muscular atrophy and strength decrease recovered and other three cases partly recovered. All patients were satisfied with the outcome of surgical treatment.　Conclusions　Non-fusion procedures show a favorable prospective over ADCF in surgical treatment for single-level cervical spondylotic radiculopathy.