CAJ | 학술논문

目的：探讨颈前路减压融合内固定治疗中老年颈脊柱前纵韧带断裂无骨折脱位型颈脊髓损伤患者的临床疗效。方法回顾性分析2007年1月至2011年12月期间，伴前纵韧带断裂无骨折脱位型颈脊髓损伤28例中老年患者，采用颈椎前路减压Cage置入椎体间融合Zephir钢板内固定的临床资料。结果28例患者均获随访20~60个月，平均36个月。每例患者手术时间30~55min，平均40min，出血量20~110ml，平均50ml，术后1例出现吞咽异物感，1周后症状消失；1例出现脑脊液漏，经留置引流管2周换药后创面完全愈合；无喉返神经及椎动脉损伤；住院时间平均8d；脊髓功能按Frank分级平均提高1.5级；随访X线片示椎间融合良好，内固定物稳定，无螺钉松动及假关节形成；椎间高度及颈椎生理曲度维持良好。优良率：优19例、良8例、差1例，优良率为96.4%。结论颈前路减压融合内固定治疗伴前纵韧带断裂无骨折脱位型颈脊髓损伤中老年患者，疗效满意，是一种安全、可靠、有效的手术方式，值得临床推广应用。
목적：탐토경전로감압융합내고정치료중노년경척주전종인대단렬무골절탈위형경척수손상환자적림상료효。방법회고성분석2007년1월지2011년12월기간，반전종인대단렬무골절탈위형경척수손상28례중노년환자，채용경추전로감압Cage치입추체간융합Zephir강판내고정적림상자료。결과28례환자균획수방20~60개월，평균36개월。매례환자수술시간30~55min，평균40min，출혈량20~110ml，평균50ml，술후1례출현탄인이물감，1주후증상소실；1례출현뇌척액루，경류치인류관2주환약후창면완전유합；무후반신경급추동맥손상；주원시간평균8d；척수공능안Frank분급평균제고1.5급；수방X선편시추간융합량호，내고정물은정，무라정송동급가관절형성；추간고도급경추생리곡도유지량호。우량솔：우19례、량8례、차1례，우량솔위96.4%。결론경전로감압융합내고정치료반전종인대단렬무골절탈위형경척수손상중노년환자，료효만의，시일충안전、가고、유효적수술방식，치득림상추엄응용。
Objective To investigate the cliniccal effect of anterior cervical decompression and fusion with internal fixation in the treatment of elderly patients with rupture of anterior longitudinal ligament of cervical spinal cord injury without fracture and dislocation. Methods A retrospective study was performed on 28 cases of elderly patients with rupture of anterior longitudinal ligament of cervical spinal cord injury without fracture and dislocation in the treatment of interbody fusion with Cage and Zephir plate from Jan 2007 to Dec 2011. Results All patients were followed up for 20 to 60 months(average 36 months). The operation time is about 30 to 55 minutes(average 40 minutes)and blood loss was 20 to 110ml(average 50ml).All patients without recurrent laryngeal nerve and vertebral artery injury. 1 cases of cerebrospinal fluid leakage was wound healing by after drainage tube with 2 weeks .According to Frank classification,the spinal cord function increase of 1.5 grade. The X films showed good internal fixation and stable interbody fusion,no looseness and pseudarthrosis;intervertebral height and cervical curves maintain good. The excellent and good rate was 96.4%(excellent in 19 cases,good in 8 cases and poor in 1 cases). Conclusion Anterior cervical decompression and fusion with internal fixation in the treatment of elderly patients with rupture of anterior longitudinal ligament cervical spinal cord injury without fracture and dislocation has advantages such as small trauma,good cervical vertebra stable,which was a safety,reliable and effective surgery way,can obtain satisfied cliniccal efficacy in elderly patient.