天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2014年
9期
925-927
,共3页
颈椎病%显微外科手术%外科手术,微创性%颈前路%脊髓减压
頸椎病%顯微外科手術%外科手術,微創性%頸前路%脊髓減壓
경추병%현미외과수술%외과수술,미창성%경전로%척수감압
cervical spondylosis%microsurgery%surgical procedures,minimally invasive%anterior cervical approach%spinal cord decompression
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。
目的：探討顯微鏡下頸椎前路手術治療頸椎病的手術療效。方法選擇在顯微鏡下採用經頸椎前路椎體次全切減壓，鈦網置入融閤內固定術或頸椎間盤切除減壓cage置入內固定術治療的頸椎病患者75例。其中1箇椎間隙41例，2箇椎間隙30例，3箇椎間隙4例。術後定期隨訪，採用日本矯形外科學會評分繫統（JOA）評分法分彆對患者術前和術後末次隨訪時脊髓功能進行評分，併計算神經功能改善率，以此評定顯微鏡下頸椎前路手術的臨床療效。結果75例患者均穫得隨訪，其神經功能改善情況為優44例，良25例，可6例，優良率為92%，各椎間隙組間優良率比較，差異無統計學意義。各椎間隙組內患者術後末次隨訪JOA評分均高于術前（均P<0.05）。結論顯微鏡下頸椎前路手術治療頸椎病安全有效，術中創傷小，齣血少，減壓徹底，術後恢複快，可早期下床活動，治療效果滿意。
목적：탐토현미경하경추전로수술치료경추병적수술료효。방법선택재현미경하채용경경추전로추체차전절감압，태망치입융합내고정술혹경추간반절제감압cage치입내고정술치료적경추병환자75례。기중1개추간극41례，2개추간극30례，3개추간극4례。술후정기수방，채용일본교형외과학회평분계통（JOA）평분법분별대환자술전화술후말차수방시척수공능진행평분，병계산신경공능개선솔，이차평정현미경하경추전로수술적림상료효。결과75례환자균획득수방，기신경공능개선정황위우44례，량25례，가6례，우량솔위92%，각추간극조간우량솔비교，차이무통계학의의。각추간극조내환자술후말차수방JOA평분균고우술전（균P<0.05）。결론현미경하경추전로수술치료경추병안전유효，술중창상소，출혈소，감압철저，술후회복쾌，가조기하상활동，치료효과만의。
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.
