两种前路减压融合术治疗颈椎病疗效对比.docVIP

两种前路减压融合术治疗颈椎病疗效对比 　 作者：何京力 ，阮狄克，侯黎升，张超，丁宇，王德利 　摘要:目的 比较Cloward法与改良Smith-Robinson法（Smith-Robinson法+钛板内固定）治疗单节段颈椎病的疗效。 方法 37例颈椎病患者分别采用Cloward法（15例）与Smith-Robinson+钛板内固定（22例）。采用SAS6.12软件对两组术式术前、术后1周、最后随访时JOA评分、融合节段及全颈椎Cobb角、融合节段椎体前高及后高进行统计学分析。 结果 随访6～48个月，平均22个月。两种术式最后随访JOA评分无显著性差异，Cloward法术后融合节段椎体高度、颈椎生理前凸无变化;改良Smith-Robinson法术后融合节段椎间高度、颈椎生理前凸部分恢复，并可以维持。 结论 近期观察证明两种手术方法都可以改善神经功能，但改良Smith-Robinson法可改善并维持融合节段椎间高度及颈椎生理前凸。 关键词: Cloward法;Smith-Robinson法;颈椎病;单节段;颈前路钛板 Intermediate Outcome of Cervical Discectomy and Fusion for Single┐level Cervical Myelopathy:A Comparative Study of Cloward Method and Modified Smith┐Robinson Method Abstract:Objective To compare the intermediate outcomes between Cloward Technique and modified Smith-Robinson technique（standard Smith-Robinson technique accompanying with anterior cervical plate）on single-level cervical myelopathy patients.Methods From June1997to June2004，37cases with cervical myelopathy secondary to single-level degenerative disc herniation received anterior decompression and inter-segment bony fusion.Among whom，15in Group A received Cloward decompression and22in Group B received modified Smith-Robinson decom-pression.Average follow-up was22months（6to48months）.Neurologic result（JOA）and radiologic results（A f ，A 2～7 ，Ha and Hp ）were examined to compare their outcome.SAS6.12Software was introduced to do statistical anal┐ysis.Results At the final follow-up time，JOA scores improved in both groups with no statistical difference existed between them，kyphotic deformity in group A did not correct，while that in group B corrected and maintained signifi-cantly as confirmed by Af ，A 2～7 Ha and H p results.Conclusion Intermediate follow-up showed both Cloward tech-nique and modified Smith-Robinson technique could improve neurological function significantly of single level cervical myelopathy，while the latter could further correct cervical kyphotic deformity and maintain cervical lordosis. Key words:cloward technique;smith-Robinson tech