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.DOCVIP

临床医学论文-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 ??????????? 作者：杨成林　毕郑钢　曹阳　付春江　杨卫良　陆晓峰　张震宇　尚剑 【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（JOA）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评分亦显著高于术前。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 　　Clinical following study of modified anterior decompession approach to treat cervical spondyllosis∥??? 　　Abstract：［Objective］To summarize and evaluate the curative effect of anterior decompression approach by using cervical retractor systems to treat cervical spondylosis.［Method］From April 2002 to October 2004,68 cases were performed anterior undermined farreaching decompression and fusion with autograft and titanium plate internal fixation by using removing disc merely at the singlelevel or separately at the multilevels employing CCR selfretractor and Caspar cervical retractor systems via interspinal approach.The cases were followed up,and serial roantgcnographic evaluations being applied.Then the height of involved intcrspinal space was measured preoperatively and after 12 months postoperatively,and the spinal function was evaluated in accordance with the standard of Japanese Orthopeadic Association（JOA）,and then all results were compared statistically.［Result］51 of all cases were followed up,of which 50 were better,1 was improved,no one worsened.After 12 months postoperatively,roentgenographic appearance showed that the allograft healing and interbody fusion of all patients were achieved,and the reserving height of involved interspinal space and JOA evaluation postoperatively were significantly superior to both preoperatively.No complications such as cervical spinal cord injury,internal fixation unfastening,and hematoma turned up.［Conclusion］Ant