前路开槽减压髂骨植骨钢板内固定治疗多节段脊髓型颈椎病

目的探讨前路减压手术在多节段脊髓型颈椎病中的应用价值。方法32例脊髓型颈椎病患者，病变累及2个椎间隙者27例，3个椎间隙者5例。经颈前路开槽式减压，28例取自体髂骨移植，4例采用钛网内充填减压椎体之松质骨植骨，并行带锁板固定。结果32例中29例随访平均32.5个月，植骨于术后12-16周骨性愈后。术后恢复之椎间高度未发生再丢现象，颈椎生理曲度维持良好。无钢板、螺钉折断、滑脱等并发症。手术有效率为93.0％（27／29），优良率为79.0％（23／29），JOA评分由平均术前8.3分上升至术后14.1分。结论多节段脊髓型颈椎病可采用前路开槽式减压及带锁钢板内固定，应用前景良好。

Multilevel cervical spondylotic myelopathy treated with anterior subtotal vertebrectomy combined with cervical spine locking plate

Objective To study the practical value of treatment of multilevel cervical spondylotic my- elopathy（CSM） through anterior approach. Method Thirty-two cases of CSM patients were studied. The pathological segments in 27 eases involved two intervertebral discs. The other 5 cases involved three intervertebral discs. All eases were treated with anterior eorpeetomy and cervical spine locking plate（CSLP） fixation. 28 cases were submitted to auto iliac bone graft. Other 4eases implanted with titanium mesh filled with cancellous bone of resected vertebra body. Result 29 cases were followed up to 32.5months in average. Solid fusion were obtained within 12 tol6 weeks postoperatively. The restoration of the intervertebral spaces were maintained after operation. The physiological curve of cervical spine is good. No complications occurred, such as breaking of the plate and screw. The effective rate of operation is 93.1% （27/29）. The excellent and good rate is 79.3% （23/29）. The JOA score rises from 8. 3 points preoperatively to 14.1 points postoperatively. Conclusion Multilevel cer- vical spondylotie myelopathy can be treated by anterior eorpectomy and CSLP fixation, and its application has shown good prospects.