颈前路椎体次全切除联合单间隙减压融合内固定治疗多节段脊髓型颈椎病的疗效分析
摘要
目的观察颈前路椎体次全切除联合单间隙减压融合内固定治疗多节段脊髓型颈椎病的临床疗效。方法回顾性分析自2015-01—2018-04采用颈前路椎体次全切除联合单间隙减压融合内固定治疗的29例多节段脊髓型颈椎病。结果 29例均获得随访,随访时间平均18(8～30)个月。术后植骨均融合良好,无神经损伤、脑脊液漏、感染、内固定物松动移位等并发症发生。末次随访时JOA评分为12～16分,平均14.8分;融合节段Cobb角9°～16°,平均13.6°。末次随访时疗效采用JOA评分标准评定:优16例,良12例,可1例,优良率96.6%。结论采用颈前路椎体次全切除联合单间隙减压融合内固定治疗多节段脊髓型颈椎病可以减少对颈椎结构的损伤和破坏,减轻手术创伤,患者颈椎生理曲度能够更加迅速、有效地恢复,避免长节段颈椎次全切除手术或前后路联合手术的创伤及并发症发生的风险。
引文
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[10]庄全魁,陈勇,李杨,等.后路椎体次全切除椎间支撑植骨治疗胸腰椎爆裂骨折疗效观察[J].蚌埠医学院学报,2014,39(9):1223-1225.
[11]谢纪宝,郑永茂,徐秀成,等.颈前路椎体次全切除联合椎间隙减压融合内固定治疗多节段颈椎病[J].临床骨科杂志,2017,10(5):520-522.
[12]宋将,郝清海,刘涛,等.颈前路ACCF联合ACDF治疗多节段脊髓型颈椎病的疗效观察[J].中国骨与关节损伤杂志,2018,33(1):49-51.
[2]Yonenobu K,Okada K,Fuji T,et al.Causes of neurologic deterioration following surgical treatment of cervical myelopathy[J].Spine(Phila Pa 1976),1986,11(8):818-823.
[3]Yamamoto Y,Hara M,Nishimura Y,et al.Hybrid method of transvertebral foraminotomy combined with anterior cervical decompression and fusion for multilevel cervical disease[J].Neurol Med Chir(Tokyo),2018,58(3):124-131.
[4]胡伟,袁建华,刘向阳,等.3节段脊髓型颈椎病前路选择性减压植骨内固定疗效分析[J].中国骨与关节损伤杂志,2014,29(3):270-271.
[5]刘长安,张卫平,王凌云,等.颈椎前路多节段椎体次全切减压植骨融合内固定术治疗多节段脊髓型颈椎病[J].解放军医药杂志,2015,12(4):24-27.
[6]黄小东,方诗元,王叙进,等.两种前路减压术治疗相邻两节段脊髓型颈椎病的疗效比较[J].安徽医学,2014,10(4):450-454.
[7]Blizzard DJ,Caputo AM,Sheets CZ,et al.Laminoplasty versus laminectomy with fusion for the treatment of spondylotic cervical myelopathy:short-term follow-up[J].Eur Spine J,2016,26(1):85-93.
[8]Liow M,Lee M,Goh GS,et al.Poorer fusion outcomes in diabetic cervical spondylotic myelopathy patients undergoing single-level anterior cervical discectomy and fusion does not compromise functional outcomes and quality of life[J].Spine,2017,12(14):43.
[9]杨春,朱裕成,朱爱祥,等.2种颈前路减压方法治疗相邻双间隙脊髓型颈椎病的疗效对比[J].中国骨与关节损伤杂志,2014,29(9):857-859.
[10]庄全魁,陈勇,李杨,等.后路椎体次全切除椎间支撑植骨治疗胸腰椎爆裂骨折疗效观察[J].蚌埠医学院学报,2014,39(9):1223-1225.
[11]谢纪宝,郑永茂,徐秀成,等.颈前路椎体次全切除联合椎间隙减压融合内固定治疗多节段颈椎病[J].临床骨科杂志,2017,10(5):520-522.
[12]宋将,郝清海,刘涛,等.颈前路ACCF联合ACDF治疗多节段脊髓型颈椎病的疗效观察[J].中国骨与关节损伤杂志,2018,33(1):49-51.