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保留椎体后壁的椎体次全切除术治疗脊髓型颈椎病

郑军   

  1. 安徽医科大学
  • 收稿日期:2010-09-30 修回日期:2010-11-10 出版日期:2011-03-15 发布日期:2011-03-15
  • 通讯作者: 郑军

Anterior cervical corpectomy and fusion with preserved posterior vertebral wall for cervical spondylotic myelopathy

  • Received:2010-09-30 Revised:2010-11-10 Published:2011-03-15 Online:2011-03-15

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摘要： 摘要 目的：探讨保留椎体后壁椎体次全切除术治疗脊髓型颈椎病的疗效，并与传统的椎体次全切除术比较。方法：脊髓型颈椎病患者40例随机分为2组，每组20例，分别行传统的椎体次全切除术和保留椎体后壁的椎体次全切除术。比较2组手术时间、出血量、并发症、节段高度、节段曲度及植骨融合评分等指标变化。结果：保留椎体后壁组较椎体次全切除术组手术时间短，出血少。2组节段高度和曲度的改善差异均无统计学意义（P>0.05），2种术式术后3个月植骨融合率均为100％。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，是治疗脊髓型颈椎病的一种比较理想的术式。

关键词: 颈椎病, 椎体成形术, 脊髓型, 减压术, 外科, 椎间盘切除术

Abstract: Abstract Objective：To study the effect of anterior cervical corpectomy and fusion with preserved posterior vertebral wall for cervical spondylotic myelopathy ,and to compare the results of anterior cervical corpectomy and fusion with preserved posterior vertebral wall with the classical anterior cervical corpectomy with fusion．Methods：From August 2007 to September 2009, 40 cases of CSM were randomized to undergo anterior cervical corpectomy with fusion (n = 20) or anterior cervical corpectomy and fusion with preserved posterior vertebral wall (n = 20). Operation time, blood loss, 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 operation time and blood loss decreased significantly in the anterior cervical corpectomy and fusion with preserved posterior vertebral wall group. Improvement in segmental lordosis and disc height were similar in both groups .Both fusion rate after 2 processes reached 100％at 3 months posteratively. Conclusion: Anterior cervical corpectomy and fusion with preserved posterior vertebral wall is a feasible procedure for anterior decompression and fusion, with shorter operation time, less bleeding. And there is smaller structural damage to the cervical vertebrae.

Key words: cervical spondylosis, vertebroplasty, spinal cord, decompression, surgical, diskectomy