Objective To compare the results of anterior cervical corporectomy and fusion with preserved posterior vertebral wall (PWCF)with the classical anterior cervical corpectomy with fusion (ACCF). Methods From August 2007 to September 2009,40 cases of CSM were randomized to undergo PWCF (n=20)or ACCF (n=20). All patients were followed up at 1 week and 3,6,12 months with three-dimensional reconstructions of CT scan and X-ray. Operative time,blood loss,days of hospitalization,the numbers and types of complications,and preoperative and postoperative JOA scores were recorded fusion rate,segmental lordosis,and disc height were assessed by roentgenography. Results Average operative time and blood loss decreased significantly in the PWCF group. Improvement in segmental lordosis disc height and JOA short-term improvement scores were similar in both groups. Both fusion rate after 2 processes reached 100％at 6 months posteratively. Conclusion PWCF is a feasible procedure for anterior decompression and fusion,with shorter operative time,less bleeding. And there is smaller structural damage to the cervical vertebrae.%目的 介绍保留椎体后壁椎体次全切除术,并与传统的椎体次全切除术比较.方法 2007-08-2009-09,40例脊髓型颈椎病患者随机行保留椎体后壁的椎体次全切除术和传统的椎体次全切除术各20例,术后1周,3、6、12个月进行随访并行X线及CT三维重建检查,比较两组年龄、手术时间、出血量、并发症、术前术后JOA评分、植骨融合评分、节段高度、节段曲度等多项指标.结果 保留椎体后壁组较传统椎体次全切除组手术时间短、出血量少.两种术式术后融合节段曲度、节段高度、JOA短期评分和植骨融合评分无明显差异.结论 保留椎体后壁的椎体次全切除术具有手术时间短、出血少、对颈椎椎体结构破坏小等优点,为脊髓型颈椎病提供了一种比较理想的手术方法.
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