CAJ | 학술논문

方法探讨保留椎体后壁的椎体次全切除联合椎间隙减压治疗多节段颈椎病的临床疗效。方法2011年2月至2013年1月，采用保留椎体后壁的椎体次全切除联合椎间隙减压治疗多节段颈椎病19例，术后1、3、6、12个月分别摄X线片、3个月时行颈椎CT三维重建了解内固定在位及植骨融合情况，并记录患者神经功能评分。结果所有患者均获得8~16个月的随访（平均10.6个月）；19例患者术前J0A评分为（10.40±1.09）分，末次随访评分为（15.46±1.15）分，差异有统计学意义（P<0.01）；其中优9例，良7例，有效3例，优良率为84.2%；术后3~4个月植骨全部融合，无钢板松动、钛网或Cage移位、椎体塌陷、假关节形成等并发症发生；2例出现声音嘶哑，2~3周后自愈。结论保留椎体后壁的椎体次全切除联合椎间隙减压治疗多节段颈椎病，具有疗效满意、操作安全、减压彻底及植骨融合可靠、术后并发症少等优点。
방법탐토보류추체후벽적추체차전절제연합추간극감압치료다절단경추병적림상료효。방법2011년2월지2013년1월，채용보류추체후벽적추체차전절제연합추간극감압치료다절단경추병19례，술후1、3、6、12개월분별섭X선편、3개월시행경추CT삼유중건료해내고정재위급식골융합정황，병기록환자신경공능평분。결과소유환자균획득8~16개월적수방（평균10.6개월）；19례환자술전J0A평분위（10.40±1.09）분，말차수방평분위（15.46±1.15）분，차이유통계학의의（P<0.01）；기중우9례，량7례，유효3례，우량솔위84.2%；술후3~4개월식골전부융합，무강판송동、태망혹Cage이위、추체탑함、가관절형성등병발증발생；2례출현성음시아，2~3주후자유。결론보류추체후벽적추체차전절제연합추간극감압치료다절단경추병，구유료효만의、조작안전、감압철저급식골융합가고、술후병발증소등우점。
Objective To study the effect ofcervical subtotal corpectomy with the posterior vertebral wall retention combinedwithintervertebral decompression for multi-level(≥3)cervical spondylosis .Methods 19 cases of multi-level(≥3)cervical spondylosis were treated with subtotal corpectomy with the posterior vertebral wall retention combinedwithintervertebral decompressionfrom 2011 February to 2013 January. Bone fusions were assessed with roentgenogram and CT during the 1st,3rd,6th,12th month follow-up and neurologic function was recorded. Results All patients were followed-up 8-16 months with an average of 10.6 months. The JOA score(15.4土1.15)at last follow-upwas significantly improved when compared with preoperative score (10.40±1.09),showing significant difference(P<0.01).Of which 9 cases were excellent,good in 7 cases, effective in 3 cases,the excellent and good rate was 84.2%.Bone fusion happened in all patients 3 to 4 months after operation. The complications that plate loosening,titanium mesh or cage shift,vertebral collapse,pseudoarticulation formation were not found. 2 patients with hoarseness recovered 2-3 weeks later. Conclusion For multi-level cervical spondylosis,subtotalcorpectomy with the posteriorvertebral wall retention combinedwithintervertebral decompression was a feasible anterior decompression procedure with advantage of safety,completely decompression and reliable bone fusion.