【摘要】 目的探讨颈椎分期前后路手术的临床应用并评价其疗效。方法回顾分析2007年1月～2010年1月,分二期手术的颈椎伤病患者32例,其中26例为一期前路二期后路,6例为一期后路二期前路,2次手术时间间隔为3～12个月。结果所有患者随访24～48个月,平均32个月。根据美国脊髓损伤协会(American Spinal Injury Asso-ciation,ASIA)评分,患者一期术后神经功能较术前有明显改善(P<0.05),二期术后仍有明显改善(P<0.05);主观满意率由一期术后的56.3%提高到二期术后的75%。所有患者均获骨性融合。颈椎生理曲度由术前平均12.8°纠正到一期术后的18.5°(P<0.01),二期术后变化不明显,随访角度无明显丢失。结论对于颈椎前后压迫较重的患者,分期前后路手术是一种安全有效的方法,可为临床提供一种手术方案选择。更多还原

【Abstract】 Objective To treat cervical spinal cord compression surgically with two-staging different approaches and evaluate it’s outcomes.Methods A total of 32 cases with cervical spinal cord compressed severely treated from January 2007 to January 2010 were retrospectively reviewed.Twenty-six patients were performed anterior surgery at first stage and posterior surgery at secondly,and another 6 patients were surgically treated with posterior approach firstly and anterior approach secondly.The interval between 2 surgical procedures was from 3 to 12 months.Results All cases were followed up for 24-48 months(mean 32 months).According to American Spinal Injury Association(ASIA) scoring,the values after first operation and the second operation elevated significantly respectively.And the satisfactory ratio was raised from 56.3% after first operation to 75% after the second operation.All cases obtained bony fusion at 4.3 months postoperatively,and the kyphotic curve was rectified from 12.8°to 18.5°after first operation.After second operation,there was no significant change.And at final follow-up,the rectification didn’t lost significantly.Conclusion For the patient with spinal cord circumferential compressed severely,two-staged surgical strategy is an effective and rational method.It can provide a surgical option for spine surgeon.更多还原