钩椎关节切除治疗神经根型颈椎病

目的 探讨颈椎钩椎关节切除,前路减压、椎体间融合治疗神经根型颈椎病的方法.方法 从2005年3月至2007年10月,共实施颈椎前路减压、钩椎关节骨赘切除40例,所有患者均采用颈椎前路减压、钩椎关节切除、自体髂骨移植和钛合金钢板内固定.为了分析这一术式的疗效,回访经手术治疗的40例神经根型颈椎病患者,并对这些患者进行了手术前和手术后6个月的神经功能评定和影像学评价,神经功能评定参考日本骨科学会(JOA)的颈椎病评分标准.结果 40例患者全部进行了疗效评价.手术时间90～30 min,出血量300～600 ml,所有患者手术后神经功能JOA评分均有所提高,手术前JOA评分平均为7.0,手术后JOA评分平均为12.3,手术后X线检查发现移植骨全部实现骨融合,未发现内固定物断裂和螺丝钉松动.本组病例未出现脊髓和神经损伤.结论 钩椎关节骨赘切除、前路减压、自体髂骨移植、钛合金钢板内固定椎体间融合治疗神经根型颈椎病术式创伤小、操作简单、安全、成功率高,术后神经功能改善,患者生活质量提高. Abstract： Objective To explore a new, modified surgical technique for removement of luschks joint osteophytes, anterior decompression and intervertebrae fusion for cervical spondylotic radiculopathy.Methods From Mar. 2005 to Oct. 2007, 40 patients with cervical spondylotic radiculopathy underwent anterior decompression and removement of luschks joint osteophytes at our hospital. All were given anterior decompression,removement of Luschks joint osteophytes,iliac bone autograft and internal fixation with titanium plates.The procedure and clinical results are discussed. To assess the efficacy of this technique, a retrospective review of neurological and radiological outcomes after operation was conducted. Neurological outcomes were evaluated according to the Japanese Orthopaedic Association (JOA) scores. Surgery -related outcome was assessed in all patients who attended more than 6 months of follow up after operations. Results Fourty patients were all involved in the result analysis. The time of operations ranged from 90 to 130 minutes. The quantity of hemorrhage ranged from 300 to 600 ml. Symptoms and physical signs were improved to different degrees. By JOA grade system,the mean scores were 7.0 points preoperatively and 12.3 points postoperatively. According to X -ray postoperatively,the implanted bone all fused and no internal fixation rupture or loose were observed.Postoperative X- ray demonstrated no hardware failure. No neurological complications were observed. Conclusions Removement of luschks joint osteophytes, anterior decompression,iliac bone autograft and internal fixation with titanium plates and intervertebrae fusion for cervical spondylotic radiculopathy can improve patients' life quality, and this technique is less invasive,simple,safe ,and reliable.

Remove of luschks joint osteophytes for cervical spondylotic radiculopathy

Cervical vertebra Cervical luschks joint Cervical spondylotic radiculopathy Decompression Internal fixators