CAJ | 학술논문

目的探讨脊髓型颈椎病前、后路手术的临床疗效.方法对86例脊髓型颈椎病患者分前路减压植骨内固定40例和后路单开门椎管成形术46例,比较两种手术方式对单节段、两节段、三节段、四节段压迫的改善率.结果随访20～73个月,平均43个月,两种减压术后JOA评分改善率在单节段压迫者差异有统计学意义(P<0.05),在两节段、三节段压迫者差异无统计学意义(P＞0.05),在四节段压迫者差异有统计学意义(P<0.05).结论脊髓型颈椎病单节段压迫者,前路手术效果好,对于两个或三个节段压迫者,前、后路手术的疗效相同,对于四个节段的压迫,后路手术效果好.
목적 탐토척수형경추병전、후로수술적림상료효.방법 대86례척수형경추병환자분전로감압식골내고정40례화후로단개문추관성형술46례,비교량충수술방식대단절단、량절단、삼절단、사절단압박적개선솔.결과 수방20～73개월,평균43개월,량충감압술후JOA평분개선솔재단절단압박자차이유통계학의의(P<0.05),재량절단、삼절단압박자차이무통계학의의(P＞0.05),재사절단압박자차이유통계학의의(P<0.05).결론 척수형경추병단절단압박자,전로수술효과호,대우량개혹삼개절단압박자,전、후로수술적료효상동,대우사개절단적압박,후로수술효과호.
Objective To investigate the prognosis of two decompression approaches for cervical spondylotic myelopathy. Methods 86 cases were divided into two groups. 40 cases were underwent decompression by anterior decompression, fusion and internal fixation with titanium screws and plate and 46 cases underwent posterior single opendoor laminoplasty. To investigate the prognosis of two decompression approaches for single compressive segment, two compressive segments, three compressive segments and four compressive segments. Results All cases were followed up for 20 ～ 73 months with an average of 43 months. The mean JOA recovery rate was significant different between single compressive segment group (P ＜ 0.05), and no significant difference between two compressive segments and three compressive segments(P ＞ 0.05), and significant difference between four compressive segments groups (P ＜0.05). Conclusion For single compressive segment, the anterior surgery has a good surgical result,for two or three compressive segments, anterior and posterior surgery had same effect, for the four compressive segments, posterior surgical effect was good.