CAJ | 학술논문

目的：探讨颈椎前路多节段椎体次全切减压植骨融合内固定术治疗多节段脊髓型颈椎病的方法和临床疗效。方法回顾性分析2008年3月—2012年6月采用颈前路多节段椎体次全切减压植骨融合内固定术治疗多节段颈椎病38例,均为3个及以上责任节段病变。观察术后手术并发症情况,根据术前、后颈椎侧位 X 线片上测量颈椎曲度 C 值,观察手术间隙融合情况,根据 JOA 评分系统进行术后疗效评价。结果术后1例发生脑脊液漏,2例出现一过性喉返神经损伤。术后12个月患者神经症状均好转,37例可见椎间隙骨性融合,术后6、12个月的颈椎曲度 C值和 JOA 评分均较术前有明显改善(P <0．05)。结论颈前路多节段椎体次全切减压植骨融合内固定术可达到充分减压,即刻重建颈椎生理曲度及稳定性,是治疗多节段颈椎病的有效方法。
목적：탐토경추전로다절단추체차전절감압식골융합내고정술치료다절단척수형경추병적방법화림상료효。방법회고성분석2008년3월—2012년6월채용경전로다절단추체차전절감압식골융합내고정술치료다절단경추병38례,균위3개급이상책임절단병변。관찰술후수술병발증정황,근거술전、후경추측위 X 선편상측량경추곡도 C 치,관찰수술간극융합정황,근거 JOA 평분계통진행술후료효평개。결과술후1례발생뇌척액루,2례출현일과성후반신경손상。술후12개월환자신경증상균호전,37례가견추간극골성융합,술후6、12개월적경추곡도 C치화 JOA 평분균교술전유명현개선(P <0．05)。결론경전로다절단추체차전절감압식골융합내고정술가체도충분감압,즉각중건경추생리곡도급은정성,시치료다절단경추병적유효방법。
Objective To investigate the surgical methods and clinical effects of anterior decompression by sub-total vertebrectomy combined with bone grafting and internal fixation in treatment of multilevel cervical spondylotic my-elopathy. Methods Clinical data of 38 patients with multilevel cervical spondylosis undergoing anterior decompression by subtotal vertebrectomy combined with bone grafting and internal fixation during March 2008 and June 2012 was retro-spectively analyzed, and three levels or more levels of segment lesions were involved in all the patients. The postoperative complications were observed, and C values of cervical curvature were measured based on preoperative and postoperative results of lateral cervical X-rays. The sagittal segmental fusion was observed, and postoperative curative effect was evalua-ted based on JOA (Japanese Orthopedic Association) score. Results There were 1 patient with cerebrospinal fluid leak-age and 2 patients with temporary recurrent laryngeal nerve injury after the operation. Neurological symptoms were im-proved in 12 month postoperatively, and intervertebral bony fusion was found in 37 patients. The C values of cervical cur-vature and the JOA scores were significantly improved in 6th and 12th month postoperatively (P < 0. 05). Conclusion Anterior decompression by subtotal vertebrectomy combined with bone grafting and internal fixation is an effective tech-nique in treatment of multilevel cervical spondylotic myelopathy, which can make full decompression, rebuilt the physio-logical cervical curvature and achieve immediate stability.