颈前路分段减压植骨融合术治疗多节段脊髓型颈椎病的临床体会

摘要

Objective To observe the clinical effect of anterior segment decompression and bone graft fusion in treatment of multi - seg-mental cervical spondylotic myelopathy,and to summarize the experience in this kind of treatment. Methods A total of 62 patients with multi -segmental cervical spondylotic myelopathy were divided into 2 groups,patients in trial group(n = 32 cases)were treated by anterior cervical de-compression and fusion with internal fixation,and patients in control group(n = 30 cases)were treated with conventional anterior cervical decom-pression. The JOA scores of two groups were assessed before treatment and 1 week,3 and 12 months after operation,and the improvement rate at 12 months after operation were recorded. The clinical effects of two groups were compared. Results JOA scores of these two groups were signifi-cantly increased after operation( P ﹤ 0. 05),and the increase in trial group was more significant( P ﹤ 0. 05). The improvement rate at 12 months after operation(62. 7% ± 3. 4% )was significantly higher than that of control group(51. 8% ± 2. 7% ,P ﹤ 0. 05). The fine rate of trial group(78. 1% )was significantly higher than that of control group(63. 3% ,P ﹤ 0. 05). Conclusion The treatment of MCSM with cervical an-terior segmental decompression and bone graft fusion can effectively provide full decompression and improve the stability of cervical spines,and the rate of bone graft fusion is high. It is an effective procedure of operation for treatment of MCSM,hence it is worthy to be clinically applied.%目的：观察颈前路分段减压植骨融合术治疗多节段脊髓型颈椎病（ MCSM）的临床疗效。方法62例MCSM 患者分为两组，治疗组（n =32例）采用颈前路减压植骨融合内固定治疗，对照组（n =30例）采用常规颈前路减压法治疗，记录两组患者术前及术后1周，3、12个月时 JOA 评分和术后12个月 JOA 评分改善率，并比较两组临床效果。结果术后两组 JOA 评分均明显上升（ P ﹤0.05），治疗组上升更为显著（ P ﹤0.05），且术后12个月 JOA 评分改善率（62.7％±3.4％）明显高于对照组（51.8％±2.7％）（ P ﹤0.05）；且治疗组术后优良率（78.1％）也明显高于对照组（63.3％）（ P ﹤0.05）。结论颈前路分段减压植骨融合术治疗 MCSM 可充分减压，提高颈椎部位的稳定性，植骨融合率高，是治疗 MCSM 的有效手术方式，值得临床推广应用。