3种颈前路减压重建术式治疗多节段颈椎病Clinical effect comparison of three different methods of anterior cervical decompression and reconstruction for the treatment of multi-level cervical myelopathy
刘军海;陈德玉;谢宁;陈宇;何志敏;郭永飞;
摘要(Abstract)：
[目的]比较颈前路减压3种术式治疗多节段颈椎病的临床疗效及影像学变化。[方法]选择52例由同一组医师行颈前路减压术的连续三间隙病变的多节段颈椎病患者,依据手术方式不同分为:第1组:颈前路多椎体次全切除减压+长钛网植骨融合组(16例);第2组:多椎间隙减压cage植骨融合组(18例);第3组:钛网与cage组合使用组(18例)。t检验比较3组之间椎间高度变化、方差分析法比较JOA评分改善率。[结果]3组患者术后随访JOA评分均有不同程度提高,但3组间无明显统计学差异;第1组术后早期椎间高度有丢失趋势(P<0.05),并有3例明显钛网下沉,2例内植物松动,第2组无松动或下沉病例,第3组有1例钛网下沉。[结论]3种方法均可得到可靠的临床效果,但在术后稳定性及椎间高度维持方面第2、3组较第1组满意。
关键词(KeyWords)： 多节段颈椎病;颈前路减压;融合;钛网;椎间融合器
基金项目(Foundation):
作者(Author): 刘军海;陈德玉;谢宁;陈宇;何志敏;郭永飞;
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参考文献(References)：
- (1)Yonenobu K,Fu ji T,Onok,et al.Choice of surgical treatm ent formu l-tisegm ental cervicalmyelopathy[J].Sp ine,1985,10(8):710-713.
- (2)Edwards CC,R iew KD,et al.Cervical myelopathy,current d iagnosticand treatm ent strategies[J].Sp ine,2003,3(1):68-81.
- (3)Barsa P,Suchom el P,et al.Mu ltiple-level instrum ented anterior cervi-cal fusion:a risk factor for non-un ion?A prospective study w ith a m in-imum of 3-year follow-up[J].Acta Ch it O rthop Tranmatol Ceeb,2004,71(3):137-141.
- (4)Narotam PK,Pau ley SM,M cG inn,G J.Titan ium m esh cages for cervicalsp ine stab ilization after corpectomy:a clin ical and rad iological study[J].Neurosurg Sp ine,2003,99(2):172-180.
- (5)Huang JJ,N iu CC,et a l.Anterior cervica l sp ina l surgery for mu lti-leve l cervica l m ye lopathy[J].Chang Gung M ed J,2 0 0 4,2 7(7):5 3 1-5 4 1.
- (6)陈德玉、贾连顺、袁文,等.颈椎前路经椎间隙减压syncage椎体间融合[J].中国矫形外科杂志,2002,10(13):1264-1266.
- (7)许卫兵,吕刚,贾连顺,等.多节段颈椎病前路两种手术方式探讨[J].脊柱外科杂志,2005,3(3):170-171.
- (8)Lu J,Ebraheim NA,Huntoon M,et al.Cervical intervertibral d iscspace narrow ing and size of intervertibral foram ina[J].C lin O rthop,2000,(370):259-263.
- (9)Smgh K,Vaecaro AR,et al.Enhancem ent of stab ility follow ing anteriorcervical corpectomy:a b iom echan ical study[J].Sp ine,2004,29(8):845-849.
- (10)Vaccaro AR,Falatyn SP.Early failure of long segm ent anterior cervicalplate fixation[J].Sp inal D isord,1998,11(5):410-415.
- (11)W ang JC,M cDonough PW,Endow KK,et al.The effect of cervicalplating on single-level anterior cervical d isectomy and fusion[J].Sp ine D iscord,1999,6(2):467-471.