临床骨科杂志2017，Vol.20Issue(2)：129-132,4.DOI:10.3969/j.issn.1008-0287.2017.02.001
一期颈椎改良后路联合前路减压治疗不稳定型多节段脊髓型颈椎病
One stage modified posterior approach combined anterior decompression for the treatment of unstable multi-segment cervical spondylosis myelopathy
摘要
Abstract
Objective To investigate the short term clinical effect of one stage modified posterior approach combined with selective anterior decompression for the treatment of unstable multi-segment cervical spondylosis myelopathy.Methods The 28 patients with unstable multi-segmental cervical spondylotic myelopathy were treated with one stage posterior cervical pedicle screw fixation, single open-door decompression combined with anterior discectomy cage bone graft and internal fixation with titanium plate, sagittal diameter of spinal canal, cervical curvature, JOA score, VAS, nerve function improvement were evaluated before and after the operation.Results All patients were followed up for 12~24 (16.24±3.52) months.Preoperative cervical curvature 2.1°~ 9.0°(5.41°±3.81°), last follow-up cervical curvature 6.2°~11.2°(8.40°±2.41°);sagittal diameter of spinal canal: preoperative 5.2 ~11.8 (8.82±3.13) mm, last follow-up 11.4 ~ 16.8 (13.81±2.32) mm;JOA score: preoperative 8.4~11.3 (9.45±0.96) points, last follow-up 13~16 (15.56±0.64);neck pain VAS: preoperative 3.6 ~6.6 (4.96±1.50) points, last follow-up 1.0~ 2.6 (1.77±0.80);the upper limb VAS: preoperative 5.2~ 7.6(6.66 ±0.80) points, last follow-up 1.3~2.8 (1.86±0.83) points, the above indicators patients before and after surgery were statistically significant (P<0.05).Hoarseness, incision infection and incision hematoma, C5 nerve root paralysis, collapse, internal fixation loosening and other complications were not found in patients with axial pain;symptomatic treatment after 2 months was significantly relieved in 2 cases after operation, 1 case with dysphagia improved after symptomatic treatment for 1 week.Conclusions Short term clinical efficacy is satisfactory for modified posterior approach combined with anterior decompression in the treatment of unstable multi-segment cervical spondylosis myelopathy.关键词
脊髓型颈椎病/单开门椎板成形术/钉棒系统/内固定Key words
cervical spondylosis myelopathy/single open-door laminoplasty/screw-rod system/internal fixation分类
医药卫生引用本文复制引用
唐少龙,黄庆华,蒋会平,吴罗根,周文华,曹华敏,陈大勇..一期颈椎改良后路联合前路减压治疗不稳定型多节段脊髓型颈椎病[J].临床骨科杂志,2017,20(2):129-132,4.基金项目
湖南省卫生计生委科研计划课题项目资助 (编号:C2017074) （编号:C2017074）
