保留椎体后壁的前路减压术治疗多节段颈椎病

目的探讨保留椎体后壁的颈前路减压融合术对多节段脊髓型颈椎病的疗效,并与传统的椎体次全切除术比较。方法2006年3月~2007年4月,收治多节段脊髓型颈椎病患者36例,其中男22例,女14例,年龄为38~72岁,平均55.61岁。以上病例随机分成2组,每组18例,分别行传统的椎体次全切除术和保留椎体后壁的颈前路椎体次全切除植骨融合术。比较两组手术时间、出血量、并发症、术后JOA评分、植骨融合率等各项指标。结果两种术式术后3个月植骨融合率均为100%,JOA评分改善无明显差异。保留椎体后壁组手术时间短,出血少。结论保留椎体后壁的颈前路减压融合术具有手术时间短、出血少、手术风险小、减压彻底等优点,对颈椎椎体结构干扰破坏小,植骨融合率高,术后并发症少,是一种比传统的椎体次全切除植骨融合术更理想的术式。

Anterior cervical corpectomy and fusion with preserved posterior vertebral wall for multi-level cervical spondylosis

Objective To study the effect of anterior cervical corpectomy and fusion with preserved posterior vertebral wall (PWCF) for multi-level cervical spondylosis, and compare it with classical anterior cervical corpectomy with fusion (ACF). Methods From March 2006 to April 2007, 36 patients (22 male and 14 female) ,with multi-level cervical spondylosis, underwent randomly PWCF (n=18) or ACF (n=18). The age at operation ranged from 38 to 72 years, with a mean of 55.6. Operation time, bleeding quantity, complications, fusion rate and JOA score were compared between the two groups by different processes. Results Both fusion rate after 2 processes reached 100% at 3 months postoperatively, and improvement rate of JOA score had no statistical difference between the two groups at last follow-up. PWCF had advantages of shorter operation time and less bleeding quantity. Conclusion PWCF is superior to ACF owe to shorter operation time, less bleeding quantity and lower risk.