Quadrant工作通道下颈椎前路手术的初步报告

目的探讨Quadrant通道下颈椎前路减压植骨融合内固定技术的可行性、临床手术技巧及疗效。方法自2009年6月至2011年12月，共对20例颈椎疾患患者施行Quadrant通道下的颈椎前路减压植骨融合内固定手术。其中男9例，女11例；年龄36～61岁，平均48．5岁；病程6～20个月；病变节段单间隙13例，双间隙7例，其中C3～C4例，C4～56例，C5-68例，C6-72例。其中外伤性颈椎间盘突出症3例，脊髓型颈椎病13例，神经根型颈椎病3例，后纵韧带骨化症1例。结果随访时间6～30个月，平均14．3个月。手术时间50—140min，平均90min；术中出血量30—150mL，平均90mL。本组无术中并发症，术后无咽喉部刺激症状（疼痛、吞咽困难）。术前临床症状均有不同程度好转，症状改善优良率为95％。结论Quadrant通道下实施颈椎前路减压植骨融合内固定手术具有颈前软组织牵拉轻、术后咽喉部创伤反应小及手术视野清晰等特点，适用于C3～4～C6～7区域内的不超过两个间隙的椎间盘摘除或单间隙的椎体次全切除颈椎前路手术。

Preliminary Report of Anterior Cervical Operation Via Mast Quadrant Retractor

Objective To explore the technical feasibility and effects of anterior cervical opration via Mast Quadrant retractor. Methods From June 2009 to December 2011,20 patients underwent anterior cervical operation via Mast Quadrant retractor, including 9 males and 11 females. The average age was 48.5 years （range, 36 - 61 years ）. The disorders lasted from 6 to 20 months before surgery. There were 3 cases of cervical injury associated cervical disc herniation, 13 cases of cervical spondylotic myelopathy,3 cases of radiculopathy, and 1 case of solitary ossification of the posterior longitudinal ligament. Results All 20 cases were followed up for 6 to 30 months. The surgery lasted an average of 90 min （range 50 to 140 min） , mean blood loss was 90 mL （range,from 30 to 150 mL）. There was no complication during operation and no any stimulating symptoms on laryngopharynx after surgery. For cervical spondylotic myelopathy patients, according to Odom＇ s scoring system,95% patients gained excellent and good results. Conclusion The anterior cervical interbody fusion via Mast Quadrant retractor is helpful to reduce the soft tissue injury and the incidence of stimulating symptoms on laryngopharynx,which makes the surgery safer. The indications for this procedure include no more than two gap anterter discectomy or single-gap anterior corpectomy on C3-4 to C6-7 segments.