压迫性颈脊髓病再手术原因分析

目的：探讨压迫性颈脊髓病再手术的原因。方法：回顾性分析308例压迫性颈脊髓病再手术患者的临床及影像学资料。结果：颈前路术后再手术的原因有：合并发育性颈椎管狭窄115例;合并颈椎后纵韧带骨化30例;上、下节段间盘再突出25例;脊髓减压不充分24例;“跳跃式”间盘切除10例。颈后路术后冉手术的原因有：减压范围不足77例;开门上、下节段压迫脊髓14例;前方椎间盘仍压迫脊髓9例：单开门术后再关门4例。结论：手术前充分分析颈脊髓受压的病理因素,合理选择术式、改善手术技术是减少压迫性颈脊髓病冉手术率的重要措施。

Analysis of the cause for reoperation of oppressive cervical myelopathy

Objective: To evaluate the cause for reoperation of oppressive cervical myelopathy. Method: 308 cases of oppressive cervical myelopathy that had undergone reoperation were studied retrospectively.Result: Cause for reoperation of anterior cervical decompression:myelopathy with developmental spinal stenosis,115 cases;myelopathy with cervical OPLL,30 cases;adjacent disc prolapse,25 cases;inadequate decompression,24 cases;"separated" discectomy,10 cases.Cause for reoperation of posterior cervical decompression:inadequate posterior decompression,77 cases;spinal cord compression by adjacent laminas,14 cases;spinal cord compression by anterior discs,9 cases;door-closing after single open door decompression,4 cases.Conclusion: Evaluating the pathological mechanism of the cervical myelopathy,Choosing reasonable operative methods,and improving techniques of surgery can decline the reoperation rates.