颈椎一期前后路手术中前路cage固定与钢板固定的疗效比较

目的探索一期颈椎前路cage固定、后路单开门椎管扩大成形术和一期颈椎前路钢板固定、后路单开门椎管扩大成形术的疗效。方法选择颈椎病患者88例，48例一期颈椎前路单节段cage固定、后路单开门椎管成形术（A组）；40例一期颈椎前路单节段钢板固定、后路单开门椎管成形术（B组）。术后定期随访及行X线片、CT检查，观察疗效、椎间高度、椎间夹角、融合情况及后路单开门椎管矢状径增加量。结果88例平均随访14个月，A组和B组的术后疗效良好，两组术后的疗效无显著性差异（P〉0．05）；两组术后椎间高度均与术前有显著性差异（P〈0．05），两组术前、术后椎间高度无显著性差异（P〉0．05）；两组术后椎间夹角均与术前有显著性差异（P〈0．05），两组术前、术后椎问夹角无显著性差异（P〉0．05）；A组3个月融合率为89．6％，6个月融合率为100％。B组3个月融合率为90％，6个月融合率为100％，两组3个月及6个月融合率无显著性差异；两组后路单开门矢状径增加量均无丢失。结论一期颈椎前路cage固定、后路单开门椎管成形术和一期颈椎前路钢板固定、后路单开门椎管成形术均有良好疗效。

A comparative study on the therapeutic effect Of one-stage combined anterior-posterior cervical decompression with different internal fixations

Objective To compare the therapeutic effect of one-stage combined anterior-posterior cervical decompression with different internal fixations-cervical intervertebral fusion cage and cervical plate-screw fixation. Methods The follow-up was more than one year for 88 eases. 48 patients underwent one-stage combined anterior cervical intervertebral fusion and posterior cervical unilateral expansive laminoplasty （group A）; 40 patients underwent one-stage combined anterior plate-screw fixation and posterior cervical unilateral expansive laminoplasty （group B）. X-ray and CT were taken after operation to observe the clinical effect, intervertehral height, intervertebral angles, fusion rate and the increment of sagittal diameter, Results The average follow-up was 14 months. The therapeuticl effect was good in both groups. There was no significant difference of the therapeutic effect between two groups. The intervertebral height and intervertebral angles recovered in two groups, and there was no significant difference of intervertebral height and intervertebral angles between two groups. The fusion rates of groups A and group B 3 months post operation were 89.6% and 90% respectively, and the fusion rates of both groups 6 months post operation were 100%. There was no significant difference of the fusion rate between two groups. The increment of sagittal diameter in two groups was not lost. Conclusions The therapeutic effect is good in two groups.