不同术式治疗单间隙脊髓型颈椎病的疗效比较

The comparison of therapeutic efficacy between two methods in treatment of single level cervical spondylotic myelopathy

中文关键词:  颈椎病 椎体切除 脊柱融合 前路减压 内同定

英文关键词:CSM,Resection of vertebral body,Spine fusion,Anterior decompression,Bicortical graft

中文摘要:

  目的:比较单纯环锯减压柱状植骨与椎体次全切除块状植骨加内固定治疗单间隙脊髓型颈椎病的效果。方法:对91例单间隙脊髓型颈椎病患者分别采用单纯前路环锯减压柱状双面皮质骨植骨术(45例)及椎体次全切除减压块状双面皮质骨植骨加内固定术(46例)治疗,术后根据JOA评分及X线表现比较两组病例的改善率、植骨融合率及融合节段高度丢失情况。结果:平均随访15个月,环钻减压组平均改善率为45%,优良率64%,3例并发颈脊髓损伤致瘫痪;椎体次全切除组平均改善率为72%,优良率86%,无脊髓损伤等严重并发症。两组植骨融合率均为100%。环锯减压组术后融合节段高度的丢失(平均2.1mm)明显大于椎体次全切除组(平均0.71mm)(P<0.05)。结论:椎体次全切除植骨加内固定术术中减压更为安全有效,术后对椎间隙高度的维持更为可靠,疗效优于单纯环锯减压植骨术。双面皮质骨植骨可获得满意的融合率。

英文摘要:

  Objective:To compare the value between subtotal resection of vertebral body with internal fixation and simple trephine decompression in treatment of single level CSM.Method:91 CSM patients were treated with anterior trephine decompression(guoup A,45 cases