中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2011年
8期
684-687
,共4页
罗春山%邱冰%李波%田晓滨%周焯家%彭智%简月奎%赵伟峰
囉春山%邱冰%李波%田曉濱%週焯傢%彭智%簡月奎%趙偉峰
라춘산%구빙%리파%전효빈%주작가%팽지%간월규%조위봉
脊柱损伤%颈椎%椎管狭窄%减压术,外科%骨折固定术,内
脊柱損傷%頸椎%椎管狹窄%減壓術,外科%骨摺固定術,內
척주손상%경추%추관협착%감압술,외과%골절고정술,내
Spinal injuries%Cervical vertebrae%Spinal stenosis%Decompression,surgical%Fracture fixation,internal
目的 探讨Ⅰ期后前路减压、植骨固定术治疗严重下颈椎椎管骨性狭窄的临床疗效。方法 2006年4月- 2009年3月采取Ⅰ期后路减压、前路减压植骨固定术治疗严重下颈椎椎管骨性狭窄患者29例，其中颈椎陈旧性骨折11例，颈椎后纵韧带钙化7例，颈椎间盘突出钙化11例。病程2个月～3.2年，平均1.4年。术前神经功能按Frankel分级：B级2例，C级19例，D级8例；日本骨科学会( JOA)术前平均评分为9.8分。结果 本组患者随访7～28个月，平均15.2个月。植骨块于术后5个月骨性融合，融合率为100％。所有患者Frankel分级平均提高1.2级，神经症状均有明显减轻。JOA脊髓功能术后平均评分为13.8分，平均提高4.0分，平均改善率为55.6％。结论 Ⅰ期后前路减压、植骨固定术是治疗严重颈椎管骨性狭窄的安全有效的方法，术中可进行电生理监护以提高手术的安全性。
目的 探討Ⅰ期後前路減壓、植骨固定術治療嚴重下頸椎椎管骨性狹窄的臨床療效。方法 2006年4月- 2009年3月採取Ⅰ期後路減壓、前路減壓植骨固定術治療嚴重下頸椎椎管骨性狹窄患者29例，其中頸椎陳舊性骨摺11例，頸椎後縱韌帶鈣化7例，頸椎間盤突齣鈣化11例。病程2箇月～3.2年，平均1.4年。術前神經功能按Frankel分級：B級2例，C級19例，D級8例；日本骨科學會( JOA)術前平均評分為9.8分。結果 本組患者隨訪7～28箇月，平均15.2箇月。植骨塊于術後5箇月骨性融閤，融閤率為100％。所有患者Frankel分級平均提高1.2級，神經癥狀均有明顯減輕。JOA脊髓功能術後平均評分為13.8分，平均提高4.0分，平均改善率為55.6％。結論 Ⅰ期後前路減壓、植骨固定術是治療嚴重頸椎管骨性狹窄的安全有效的方法，術中可進行電生理鑑護以提高手術的安全性。
목적 탐토Ⅰ기후전로감압、식골고정술치료엄중하경추추관골성협착적림상료효。방법 2006년4월- 2009년3월채취Ⅰ기후로감압、전로감압식골고정술치료엄중하경추추관골성협착환자29례，기중경추진구성골절11례，경추후종인대개화7례，경추간반돌출개화11례。병정2개월～3.2년，평균1.4년。술전신경공능안Frankel분급：B급2례，C급19례，D급8례；일본골과학회( JOA)술전평균평분위9.8분。결과 본조환자수방7～28개월，평균15.2개월。식골괴우술후5개월골성융합，융합솔위100％。소유환자Frankel분급평균제고1.2급，신경증상균유명현감경。JOA척수공능술후평균평분위13.8분，평균제고4.0분，평균개선솔위55.6％。결론 Ⅰ기후전로감압、식골고정술시치료엄중경추관골성협착적안전유효적방법，술중가진행전생리감호이제고수술적안전성。
Objective To explore the clinical outcome of one stage posteroanterior decompression and bone implant in the treatment of severe lower cervical spinal bony canal stenosis. Methods The study involved 29 patients with severe lower cervical spinal bony canal stenosis treated with one stage posteroanterior decompression and bone implant from April 2006 to March 2009. There were 11 patients with old fractures, seven with posterior longitudinal ligament ossification and 11 with cervical disc calcification. The course of disease ranged from 2 months to 3.2 years, average 1.4 years. The nerve function was rated as grade B in two patients, grade C in 19 and grade D in eight according to Frankel scale. The average Japanese Orthopaedic Association (JOA) score was 9.8. Results All patients were followed up for 7-28 months (average 15.2 months), which showed bony fusion five months after operation, with fusion rate of 100％. The Frankel grade was increased for average 1.2 grades and the nervous symptoms alleviated remarkably. Mean postoperative JOA score was 13.8 and increased for mean 4.0, with mean amehoration rate of 55.6％. Conclusions One stage posteroanterior decompression and bone implant is a safe and effective method for treatment of lower cervical spinal bony canal stenosis, when the intraoperative electrophysiological monitoring can assure the operative safety.
