前路减压并不同融合方法治疗脊髓型颈椎病的疗效比较

目的 :比较前路减压并不同植骨融合方法治疗脊髓型颈椎病的临床疗效。方法 :对 98例单节段及双节段病变的脊髓型颈椎病患者采用前路减压并植骨融合治疗 ,其中单纯植骨融合 42例、Ray TFC融合 18例、植骨融合并颈椎前路钢板内固定 3 8例。所有病例均随访 1年以上 ,采用JOA评分 ,比较不同植骨融合方法的疗效。结果 :所有患者术后JOA评分均有改善 ,单纯植骨融合组的JOA评分改善率为5 2 .8% ,Ray TFC组为 5 4.3 % ,钢板固定组为 5 1.6% ,各组JOA评分改善率无显著性差异 (P >0 .0 5 )。 结论 :脊髓型颈椎病的治疗关键在于充分减压及有效植骨融合 ,不同融合技术对疗效无明显影响。

Comparison of anterior decompression and different spinal fusion methods for cervical spondylotic myelopathy

Objective: To analyze the clinical outcomes of anterior decompression and different spinal fusion methods for the treatment of cervical spondylotic myelopathy. Methods: Ninety-eight patients with one or two-segment cervical spondylotic myelopathy were treated by anterior decompression and interbody fusion, including autogenous iliac bone grafting in 42, Ray-TFC in 18 and autogenous iliac bone grafting plus anterior cervical plate-screw fixation in 38. All patients were followed up for more than one year and improvement rate of JOA was used to evaluate the clinical outcomes. Results: All patients had JOA improvement after surgery. The improvement rate of JOA was 52.8 per cent for iliac grafting group, 54.3 per cent for Ray-TFC group and 51.6 per cent for plate-screw fixation group, respectively. No statistical significance was noted among these three groups ( P >0.05). Conclusion: Effective anterior decompression and solid fusion are vital for cervical spondylotic myelopathy, and different fusion methods do not affect the clinical outcome.