CAJ | 학술논문

背景：近年来，许多国内外学者采用联合非融合及融合固定治疗多节段脊髓型颈椎病，取得良好临床效果，但相关远期临床疗效及可能出现的并发症还需要长期的随访进行更深入的研究。 　　目的：综述颈椎前路融合与非融合内固定2种方式在治疗脊髓型颈椎病中的研究与应用进展。 　　方法：由第一作者用计算机检索2004年1月年至2014年1月中国期刊全文数据库和美国PubMed数据库中有关于前路融合、非融合手术治疗脊髓型颈椎病的文章。中文检索词为“植入物材料；脊髓型颈椎病；前路；手术；融合；非融合；进展；杂交；综述”。英文检索词为“implant material；cervical spondylotic myelopathy；anterior；surgery/operation；fusion；non-fusion；research progress；hybrid；summary”。纳入35篇文章进行综述。 　　结果与结论：颈椎前路融合与非融合固定方式在治疗脊髓型颈椎病时各具优势，从适应证来看，非融合固定方式相对局限。目前，融合固定仍是治疗脊髓型颈椎病的主要方法。非融合固定作为一种新出现的固定方法也取得了良好的近期效果，但其有待于更长时间的随访研究。Hybrid 固定可综合上述两者的优势，减压的同时减少了融合节段，尽可能的保留颈椎的活动度，目前已成为研究热点。但是目前关于Hybrid固定的研究大多是回顾性研究，缺乏对照，总体随访时间短，需要进更一步的研究来证实。
배경：근년래，허다국내외학자채용연합비융합급융합고정치료다절단척수형경추병，취득량호림상효과，단상관원기림상료효급가능출현적병발증환수요장기적수방진행경심입적연구。 　　목적：종술경추전로융합여비융합내고정2충방식재치료척수형경추병중적연구여응용진전。 　　방법：유제일작자용계산궤검색2004년1월년지2014년1월중국기간전문수거고화미국PubMed수거고중유관우전로융합、비융합수술치료척수형경추병적문장。중문검색사위“식입물재료；척수형경추병；전로；수술；융합；비융합；진전；잡교；종술”。영문검색사위“implant material；cervical spondylotic myelopathy；anterior；surgery/operation；fusion；non-fusion；research progress；hybrid；summary”。납입35편문장진행종술。 　　결과여결론：경추전로융합여비융합고정방식재치료척수형경추병시각구우세，종괄응증래간，비융합고정방식상대국한。목전，융합고정잉시치료척수형경추병적주요방법。비융합고정작위일충신출현적고정방법야취득료량호적근기효과，단기유대우경장시간적수방연구。Hybrid 고정가종합상술량자적우세，감압적동시감소료융합절단，진가능적보류경추적활동도，목전이성위연구열점。단시목전관우Hybrid고정적연구대다시회고성연구，결핍대조，총체수방시간단，수요진경일보적연구래증실。
BACKGROUND:In recent years, many scholars adopted a joint non-fusion and fusion spinal fixation for multisegmental cervical spondylotic myelopathy, and achieved good clinical results. However, long-term clinical efficacy and possible related complications also require long-term fol ow-up of more in-depth study. OBJECTIVE:To review the research and application progress of anterior fusion and non-fusion fixation surgical operation for cervical myelopathy. METHODS:Computer-based search was conducted in China Journal Ful-text Database and PubMed database by the first author for articles related to anterior fusion and non-fusion fixation surgical operation for cervical myelopathy published between January 2004 and January 2014. The key words were“implant material;cervical spondylotic myelopathy;anterior;surgery;fusion;non-fusion;progress;hybrid;summary”in Chinese and“implant material;cervical spondylotic myelopathy;anterior;surgery/operation;fusion;non-fusion;research progress;hybrid;summary”in English. Final y, 35 articles were included for review. RESULTS AND CONCLUSION:Fusion and non-fusion fixation methods for cervical spondylotic myelopathy had their own advantages. From the view point of indications, the non-fusion fixation was relatively limited. Currently, the fusion fixation was stil the main method in treatment of cervical myelopathy. Non-fusion method as an emerging fixation method also achieved good short-period results, but it needs a long fol ow-up study. Hybrid fixation integrates the advantages of both methods, and can reduce the pressure. Simultaneously, Hybrid fixation also can reduce fusion segments, and retain the range-of-motion of the cervical spine as much as possible. Hybrid fixation becomes a hot topic in recent studies. However, most current researches on Hybrid fixation are retrospective study, lack of control. The overal fol ow-up time is short. Thus, Hybrid fixation needs to be researched more deeply.