椎间撑开颈前路减压植骨钢板内固定术治疗脊髓型颈椎病.docx

椎间撑开颈前路减压植骨钢板内固定术治疗脊髓型颈椎病【摘要】［目的］总结并探讨椎间撑开颈前路减压植骨术治疗脊髓型颈椎病的疗效。［方法］自2001年4月～2004年10月，应用CCR颈前路自动拉钩及Caspar椎体间撑开器系统，采用单节段单纯间盘切除、经椎间隙入路或多节段分别间盘切除、椎管潜式扩大减压、植骨、钛板内固定术治疗脊髓型颈椎病68例，随访并复查X线片，测量术前及术后12个月病变椎间隙高度，同时，采用日本矫形外科学会评分标准评价手术前后脊髓功能，并统计比较。［结果］全部病例中51例获得随访其中症状明显好转50例，缓解1例，加重0例。术后12个月时，X线片显示全部病例植骨愈合、病变椎间隙骨性融合。同时，手术后病变椎间隙高度保持明显优于手术前，手术后脊髓功能JOA评分亦显着高于术前。本组无颈髓损伤、钢板和螺钉松动及椎前血肿等并发症发生。［结论］椎间撑开颈前路减压植骨钢板内固定术有利于术后颈椎病变椎间隙高度的保持，并可确切恢复、改善脊髓功能。【关键词】颈椎病手术治疗颈间盘切除术内固定椎间融合Clinicalfollowingstudyofmodifiedanteriordecompessionapproachtotreatcervicalspondyllosis∥Abstract：［Objective］Tosummarizeandevaluatethecurativeeffectofanteriordecompressionapproachbyusingcervicalretractorsystemstotreatcervicalspondylosis.［Method］FromApril2002toOctober2004,68caseswereperformedanteriorunderminedfarreachingdecompressionandfusionwithautograftandtitaniumplateinternalfixationbyusingremovingdiscmerelyatthesinglelevelorseparatelyatthemultilevelsemployingCCRselfretractorandCasparcervicalretractorsystemsviainterspinalcaseswerefollowedup,andserialroantgcnographicevaluationsbeingtheheightofinvolvedintcrspinalspacewasmeasuredpreoperativelyandafter12monthspostoperatively,andthespinalfunctionwasevaluatedinaccordancewiththestandardofJapaneseOrthopeadicAssociation,andthenallresultswerecomparedstatistically.［Result］51ofallcaseswerefollowedup,ofwhich50werebetter,1wasimproved,noone12monthspostoperatively,roentgenographicappearanceshowedthattheallografthealingandinterbodyfusionofallpatientswereachieved,andthereservingheightofinvolvedinterspinalspaceandJOAevaluationpostoperativelyweresignificantlysuperiortobothcomplicationssuchascervicalspinalcordinjury,internalfixationunfastening,andhematomaturnedup.［Conclusion］Anteriordecompressionapproachbyusingcervicalretractorsystemstotreatcervicalspondylosiscouldbetterreservetheheightofinvolvedinterspinalspace,andimprovethespinalfunctionsignificantly.Keywords：cervicalspondylosis;surgicaltreatment;cervicalintervertebraldiscectomy;interbodyfusion脊髓型颈椎病临床常见。长期以来，颈前路单节段开窗减压或多节段联合开槽扩大减压，植骨融合术已