[1]储建军 裴少保 王涛 李定滨 李键.前路不同术式治疗多节段颈椎病[J].中国微创外科杂志,2014,14(5):454-457.
　Chu Jianjun,Pei Shaobao,Wang Tao,et al.Long Segment Cervical Corpectomy versus Discectomy Combined with Corpectomy for Multilevel Cervical Spondylotic Myelopathy[J].Chinese Journal of Minimally Invasive Surgery,2014,14(5):454-457.
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前路不同术式治疗多节段颈椎病()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
14
期数:
2014年5期
页码:
454-457
栏目:
短篇论著
出版日期:
2014-05-20

文章信息/Info

Title:
Long Segment Cervical Corpectomy versus Discectomy Combined with Corpectomy for Multilevel Cervical Spondylotic Myelopathy
作者:
储建军 裴少保 王涛 李定滨 李键
合肥市滨湖医院脊柱外科，合肥230061
Author(s):
Chu Jianjun;  Pei Shaobao;  Wang Tao;  et al.
Department of Spine Surgery， Hefei Binhu Hospital， Hefei 230061, China
关键词:
多节段脊髓型颈椎病; 椎间盘切除术; 椎体次全切除术; 植骨融合; 内固定术
Keywords:
Multilevel cervical spondylotic myelopathy; Discectomy; Corpectomy;  Bone graft fusion; Internal fixation
分类号:
R681.5+3
文献标志码:
A
摘要:
目的探讨长节段椎体次全切钛网植骨融合钢板内固定术和椎间盘摘除联合椎体次全切植骨融合钢板内固定术治疗多节段脊髓型颈椎病的临床疗效。方法回顾性分析我院2008年2月~2011年10月累及≥3个节段的脊髓型颈椎病40例，其中20例采用≥1个椎体次全切除植骨融合钢板内固定术(长节段组)，20例采用单个椎体次全切除植骨内固定+其他椎间盘单独切除植骨内固定术(分节段组)。结果长节段组和分节段组手术时间分别为（118.2±23.4)、（102.3±20.4)min,术中出血量分别为（182.4±35.8)、(164.1±23.6)ml，住院时间分别为（7.1±3.2)、（5.2±2.8)d。2组除术后6个月与术后12个月JOA评分改善率无统计学差异外（q=0.848，P>0.05；q=0.854，P>0.05），其他各时点间均有统计学差异（P<0.05）。2组术前后手术融合节段Cobb角有统计学差异(F=181.80，P=0.000；F=245.36，P=0.000)，但术后各时点Cobb角无统计学差异（P<0.05），术后12个月随访Cobb角丢失率长节段组为（6.5±0.4)%，分节段组为(5.1±03)%。2组植骨融合率术后6个月均为100％，长节段组2例术后6个月时融合，余均4个月内融合，分节段组术后4个月植骨均融合。结论2种方法治疗多节段脊髓型颈椎病均可获得满意的临床疗效。
Abstract:
ObjectiveTo explore the effect of two different anterior approaches in the treatment of multilevel cervical spondylotic myelopathy．MethodsThe clinical data of 40 cases of multilevel cervical spondylotic myelopathy treated in our hospital from February 2008 to October 2011 were retrospectively analyzed. Of the 40 patients, 20 patients were treated with one or more cervical corpectomy combined with titanium mesh fusion and internal fixation (Longsegment group) and the remaining 20 cases were treated with anterior cervical discectomy and anterior cervical corpectomy combined with bone grafting and internal fixation (Separatesegmental group).ResultsThe operative time in Separatesegmental and Longsegmental group was (118.2±23.4) and (102.3±20.4) min, respectively; the blood loss was (182.4±35.8) and (164.1±23.6) ml, respectively; the hospital stay was (7.1±32) and (5.2±2.8) d, respectively. Significant differences were found between the two groups in the improvement rate of JOA at every time point (P<0.05), except for 6 and 12 months after operation(q=0.848,P>0.05;q=0.854,P>0.05). Cobb angle were improved after operation in both groups (F=181.80,P=0.000；F=245.36,P=0.000). Angle loss rate at the 12month postoperative followup in Longsegment and Segment group was (6.5±0.4)% and (5.1±0.3)%, respectively. Two cases in Longsegment group showed bone graft fusion 6 months after operation, and the remaining patients in both groups showed bone graft fusion 4 months after operation．ConclusionBoth methods could obtain good clinical results in the treatment of multilevel cervical spondylotic myelopathy.

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更新日期/Last Update: 2014-12-08