天津医药

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经显微镜下颈前路手术治疗颈椎病效果观察

邵高升1,江泽华2,张学利3   

  1. 1. 天津中医药大学
    2. 南开大学 天津市人民医院
    3. 天津市人民医院脊柱外科中心
  • 收稿日期:2013-12-05 修回日期:2014-02-12 出版日期:2014-09-15 发布日期:2014-09-15
  • 通讯作者: 邵高升

To observe the curative effect of anterior cervical approach under a microscope.

SHAO Gaosheng 1,JIANG Zehua 2,ZHANG Xueli 2   

  1. 1. Tianjin University of Traditional Chinese Medicine, Tianjin 300193,China；
    2. Department of SpineSurgery, Tianjin People’s Hospital
  • Received:2013-12-05 Revised:2014-02-12 Published:2014-09-15 Online:2014-09-15
  • Contact: SHAO Gaosheng

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摘要：

【摘要】目的 探讨显微镜下颈椎前路手术治疗颈椎病的手术疗效。方法 选择在显微镜下采用经颈椎前路椎体次全切减压，钛网置入融合内固定术或颈椎间盘切除减压cage置入内固定术治疗的颈椎病患者75例。其中1 个椎间隙41例，2个椎间隙30例，3个椎间隙4例。术后定期随访，采用日本矫形外科学会评分系统（JOA）评分法分别对患者术前和术后末次随访时脊髓功能进行评分，并计算神经功能改善率，以此评定显微镜下颈椎前路手术的临床疗效。结果  75例患者均获得随访，其神经功能改善情况为优44例，良25例，可6例，优良率为92%，各椎间隙组间优良率比较，差异无统计学意义。各椎间隙组内患者术后末次随访JOA评分均高于术前（均P < 0.05）。结论  显微镜下颈椎前路手术治疗颈椎病安全有效，术中创伤小，出血少，减压彻底，术后恢复快，可早期下床活动，治疗效果满意。

关键词: 颈椎病, 颈前路, 显微外科手术, 外科手术, 微创性, 脊髓减压

Abstract:

[Abstract] Objective To assess the curative effect of microscopic anterior cervical approach in cervical spondylotic diseases. Methods A total of 75 patients were selected, who underwent microscopic subtotal anterior cervical decompres? sion and titanium mesh to fusion fixation or microscopic decompression of resection of the cervical intervertebral disc and cage implant fixation in Tianjin People's Hospital since October 2011 to October 2012. The Cervical vertebra gap involved 1 level in 41 cases, 2 levels in 30 cases and 3 levels in 4 cases. Pateints followed up regularly after operation. The nerve func? tion was assessed using Japanese orthopaedic association scoring system (JOA) function was calculated to examine the im? provement rate and to assess the curative effect of microscopic anterior cervical approach. Results All patients were fol? lowed up. The nerve function recovery was excellent in 44 cases, was well in 25 cases, was general in 6 cases, and the ex? cellent and well recovery rate was 92%. There was no significant difference between excellent recovery rate and well recov? ery rate. There were significant differences in values of each cervical levels between before and after surgery in the last fol? low-up of patients (P < 0.05). Conclusion Microscopic operative treatment for cervical spondylotic is safe and effective, with less trauma and bleeding. After surgical decompression, the recovery is rapid in patients with early ambulation.

Key words: Cervical spondylosis, Anterior cervical approach, microsurgery, surgical procedures, minimally invasive, spinal cord decompression