非连续节段颈椎病的前路手术治疗

目的 通过对25例前路手术治疗非连续节段颈椎病的临床资料回顾,探讨非连续节段颈椎病的临床特点和治疗策略.方法 选取25例非连续节段颈椎病人进行前路减压和重建.应用Cage加Cage重建14例;Cage加前路钢板固定7例;Cage加钛网和前路钢板重建4例.并以影像学检查和临床神经学检查随访20例病人的治疗结果.结果 随访时间18个月-6年3个月.平均37个月.应用JOA评分(17分法)评价手术前后的神经功能情况.术前平均评分6.2分(3-8分),术后平均评分11.4分(4-15分).有19例见到影象学融合.6例临床融合.未有内固定松动断裂,椎体间融合器下沉等.结论 对于非连续节段颈椎病,如果交界节段无退变不稳的表现,保留交界节段分别对受累节段进行减压和固定融合,是有效和安全的治疗方法.

Anterior route surgical treatment to the non-consecutive cervical spondylosis

Objective To study the clinical characteristics and therapeutic strategy of non-consecutive cervical spondylosis by reviewing 25 cases of anterior route surgical treatment.Methods 25 cases of non-consecutive cervical spondylosis have been treated with anterior decompression and reconstruction.14 cases with cage plus cage,7 cases with anterior cervical plate fixation,4 cases with Cage and Ti Mesh.We follow up the patients with image study and neurological examination.Results All patients were followed up for 18 months-6years and 3 months(average 37 months).The neurological function has been evaluated with JOA scores.Pre-operative score was 6.2(3-8) while post-operative score was 11.4(4-15).19 cases had radiological fusion.6 cases had clinical fusion.There were neither hardware failure nor subsidence of cage.Conclusion If there is no instability in the transitional segment,it is a safe and effective method that decompression and reconstruction without touching transitional segment to the non-consecutive cervical spondylosis.