天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (2): 199-202.doi: 10.11958/j.issn.0253-9896.2015.02.023

• 应用研究 • 上一篇    下一篇

Hybrid Surgery 术式治疗颈前路多节段脊髓型颈椎病的临床分析

福嘉欣， 江汉△， 江毅， 肖联平， 田永刚   

  1. 天津市第三中心医院骨科 （邮编300170）
  • 收稿日期:2014-07-14 修回日期:2014-09-30 出版日期:2015-02-15 发布日期:2015-02-27
  • 通讯作者: 江毅 E-mail:jydyl@sohu.com

Clinic analysis of Hybrid Surgery to treat multi segmental anterior cervical spondylotic myelopathy

  • Received:2014-07-14 Revised:2014-09-30 Published:2015-02-15 Online:2015-02-27

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摘要： 摘要： 目的 探讨颈椎前路经椎间隙或椎体次全切除减压植骨融合联合邻近节段人工间盘置换(Hybrid Surgery) 在颈前路多节段脊髓型颈椎病治疗中的效果。方法 应用 Hybrid Surgery 术式治疗颈前路多节段脊髓型颈椎病患者 18 例。随访 1~50 个月， 手术前后根据日本骨科协会评估分数 （JOA） 进行评分。通过 JOA 评分的改善情况， Odom’ s 分级随访结果及颈椎活动度的变化评价 Hybrid Surgery 的效果。结果 18 例术后 JOA 评分 （13.5±2.4） 分高于术前(10.6±1.7)分， 差异有统计学意义 （t= 1.314， P < 0.05）。18 例中 16 例显效， 2 例有效。Odom’ s 分级评价优 6 例， 良 11 例， 可 1 例。术后颈椎运动范围 （40.1°±8.4°） 与术前 （42.6°±11.9°） 颈椎运动范围差异无统计学意义 （t=0.68， P > 0.05）。结论 Hybrid Surgery 术式颈前路充分减压融合， 既可改善患者神经功能， 又可保留一定程度上的颈椎活动度。

关键词: 脊髓型颈椎病, Hybrid 手术, 多节段

Abstract: Abstract： Objective To investigate the effect of corpectomy decompression by subtotal vertebrectomy and fusion of adjacent segmental artificial disc replacement through anterior intervertenral spance (Hybrid Surgery) in the anteriorcervical spondylotic myelopathy treatment . Methods Hybrid Surgery were operated on 18 patients who suffered from anterior cervi⁃ cal spondylotic myelopathy . Follow up of 1-50 months. Patient’ s conditions were assessed according to the Japanese Associ⁃ ation for Department of orthopedics assessment score (JOA score) before and after operation. Effects of Hybrid operation were assessed by the improvement of JOA score, Odom’ s follow-up grade and cervical mobility . Results The JOA scores of all 18 operated patients were improved from 10.6 ± 1.7 before operation to 13.5 ± 2.4 after operation. And the difference is statistically significant (t=1.314, P < 0.05). Among all the operated patients, 16 were cured and 2 were effective. As to Odom’ s follow up grades, 6 cases were excellent, 11 cases were good and 1 case was acceptable. The postoperative move⁃ ment range of cervical spine (40.1° ± 8.4°) show no statistically difference compared with that in preoperation (42.6° ± 11.9°) (t=0.68, P > 0.05). Conclusion Hybrid Surgery of anterior cervical decompression and fusion can both improve the nerve function and preserve cervical mobility.

Key words: cervical spondylotic myelopathy, Hybrid Surgery, multi segmental