【摘要】 目的　探讨能更好地维持椎体和融合节段高度并有效防止融合节段前方塌陷的颈椎前路植骨融合方式。方法　外伤性及退变性颈椎间盘突出症共 10 2例 ,采用保留椎体终板的颈前路减压植骨融合术式 (A组 ) ,与以前所做的未保留椎体终板的颈前路减压植骨融合治疗的 78例 (B组 )进行比较。平均随访 2年 6个月 (6个月到 3年 )。术前及术后 1w内 ,术后 3个月 ,6个月 ,1年 ,2年 ,3年摄颈椎正侧位X线片 ,记录融合时间 ,测量其融合节段高度 ,并进行组间比较。结果　全部病例都骨性融合 ,未发生不融合者。B组发生融合节段前方塌陷 19例。A组平均融合时间为3.6个月 ,B组为 3.9个月 ,经t检验 ,两组骨性融合时间无显著差异 (P >0 .0 5 )。两组术后 3个月内融合节段高度无明显差异 (P >0 .0 5 ) ,术后 6个月、1年、2年、3年 ,A组平均融合节段高度明显高于B组 (P <0 .0 5 )。B组 ,术后6个月、1年、2年、3年平均融合节段高度明显低于术后 1w平均融合节段高度 (P <0 .0 5 ) ;术后 1年、2年和 3年的融合节段高度无显著差异 (P >0 .0 5 )。结论　保留终板的颈前路植骨融合术能较好地保持融合节段高度 ,并有效防止融合节段前方塌陷。更多还原

【Abstract】 Object To explore surgical treatment for the cervical myeolopathy that could effectively retain the height of intervertebral space. Methods One hundred and two cases of traumatic or non-traumatic cervical disc herniation were treated with endplate-remained anterior cervical fusion, which was hereto referred as the Group A for comparative study; 78 cases previously treated with endplate not-remained anterior fusion were hereto referred as the group B. All patients were followed-up with a period of time ranging from 6 months to 36 months, being two and half years on the average. The X-ray films for all patients were taken from the anterior-posterior and lateral sides, and at a defined time, which was within one week before operation and one week, 3, 6 ,12, 24, 36 months after operation. The height of intervertebral spaces were measured and the time of fusion were recorded, and the comparison of height and time were performed between the two groups. Results All intervertebral spaces were fused, without nonunions. There were 19 cases of anterior collapse of the fused segment in group B.The time of fusion between the two groups were not significantly different.(P>0.05) . There was no significant difference in the mean height of intervertebral space within three months after surgery, however, the mean height of intervertebral space in patients of group A was significantly higher than that in patients of group B in the period of 6 months, 1, 2, or 3 years after operation. There was a distinct decrease of the mean postoperative height of intervertebral space in patients of group B as compared between those after one week and those after 1, 2, or 3 years, however the decrease was not so distinct among the patients, who underwent surgery after 1,2 or 3 years (P>0.05). Conclusion The endplate-remained anterior cervical fusion may effectively maintain the height of intervertebral space.更多还原