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岭南现代临床外科 ›› 2010, Vol. 10 ›› Issue (01): 55-57.

• 临床研究 • 上一篇    下一篇

前后路联合颈椎管扩大成形术治疗脊髓型颈椎病

陈嘉裕,刘展亮,张惠城,李晓彬   

  1. 梅州市人民医院
  • 通讯作者: 刘展亮

Expansive Cervical Laminoplasty by Anterior and Posterior Cervical Decompression in the Treatment of Cervical Spondylosis Myelopathy

  • Received:2009-12-24 Revised:2010-01-22 Online:2010-02-20 Published:2010-02-25

摘要: 目的 评价前后路联合颈椎管扩大成形术治疗脊髓型颈椎病的临床效果。方法 回顾性分析2001~2005年间应用该术式治疗的48例脊髓型颈椎病患者。术后随访观察植骨融合率,椎间高度维持情况及其并发症。术前和术后通过神经功能JOA评分,颈部轴性症状和颈椎动态侧位片,颈椎MRI进行比较临床疗效。 结果 全部病例均获得随访,平均随访时间28个月。全部患者随访3月,6月,12月,24月JOA评分平均优良率分别为:75.0%, 81.3%, 85.4%, 89.6%。结论 前后入路治疗严重脊髓型颈椎病能彻底减压及提高植骨融合率,并有效的维持椎间高度,避免了因骨的再吸收造成椎间塌陷引起的继发神经功能损害;只要严格的掌握手术的适应证,遵循手术的操作原则,绝大多数的手术并发症均可避免发生。因此,该方法在治疗严重脊髓型颈椎病的一种较理想的治疗方法。

关键词: 脊髓型颈椎病, 颈椎, 椎管成形术, 减压, Cervical spondylosis myelopathy, Cervical vertebrae, Laminoplasty, Decompression

Abstract: Objective To evaluate the clinical results of expansive laminoplasty by anterior and posterior cervical decompression in the treatment of cervical spondylosis myelopathy. Methods 48 cases of cervical spondylosis myelopathy treated with this method from March 2001 to Februa- ry 2005 were reviewed. Neural functionality (JOA Scoring System), axial cervical symptoms, MRI and dynamic lateral x-ray of cervical vertebrae were evaluated. Results All the 48 cases had been followed-up for an average of 28 moths. The excellent and good rate when followed-up for 3, 6, 12, and 24 months were 75.0%, 81.3%, 85.4%, and 89.6%, respectively. Conclusions The met- hods of expansive cervical laminoplasty by anterior and posterior cervical decompression in the treatment of cervical spondylosis myelopathy could not only decompression thoroughly and keep the stability of cervical vertebrae, but also improve the rate of interbody fusion and maintain the interbody distance. The methods of expansive cervical laminoplasty by anterior and posterior cer- vical decompression in the treatment of cervical spondylosis myelopathy have good efficacy and it is a reliable alternative.

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