目的：探讨前路减压植骨内固定联合等离子髓核成形术治疗多节段受累颈椎病的临床效果。方法回顾性分析2012年3月至12月中山市人民医院采用前路减压植骨内固定结合等离子髓核成形术治疗的30例多节段受累颈椎病患者的临床资料，采用日本骨科学会（JOA）评分对术后临床症状改善情况进行评价。结果30例患者均获得有效随访，随访时间4～9个月（平均6.8个月）。患者术前不适症状均有不同程度改善，无神经功能加重及内固定松动、骨笼脱出等严重并发症发生。术后3个月JOA评分为（14±1）分，较术前的（10±2）分明显改善（t =8.143，P=0.000），JOA改善率为45%。结论前路减压植骨内固定结合等离子髓核成形术治疗多节段受累颈椎病近期效果稳定，并发症少。%Objective To explore clinical effect of anterior decompression, bone grafting and internal fixation combined with coblation neucleoplasty in the treatment of multilevel cervical spondylosis. Methods Clinical data of 30 patients with multilevel cervical spondylosis from March 2012 to December 2012 were retrospectively analyzed and all of them were treated by mono-segmented cervical anterior decompression, bone grafting and internal fixation combined with coblation neucleoplasty in Zhongshan People's Hospital. Clinical effects were evaluated by Japanese Orthopaedic Association (JOA) score. Results All patients obtained follow-up with the average time of 6.8 months (4-9 months). Discomfort symptoms were improved after the operation. No nerve function aggravation occurred, also, no serious complications such as internal fixation loosening or cage pull-out had happened. Compared to preoperative JOA score, JOA score at 3 months postoperatively was improved from (10 ± 2) to (14 ± 1) (t = 8.143,P = 0.000), JOA improvement rate was 45%. Conclusions Mono-segmented cervical anterior decompression, bone graft fusion combined with nucleus pulposus coblation is recommended technique for multilevel cervical spondylosis by its stable short-term effects and less complications.
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