【摘要】 目的评估后路颈椎板切除、植骨融合内固定治疗多节段脊髓型颈椎病伴节段不稳的疗效。方法对15例多节段颈椎病伴节段不稳的患者行后路颈椎板切除、减压、融合内固定术。分析手术前后JOA评分、轴性症状VAS评分、颈椎前凸角、颈椎曲度指数、脊髓向后漂移距离。结果 15例均获得随访,时间12~52个月。至末次随访,患者JOA评分、VAS评分、颈椎前凸角、颈椎曲度指数、脊髓向后漂移距离均较术前显著改善,差异均有统计学意义(P<0.01)。1例术后切口感染,1例术后C5神经根麻痹,无脑脊液漏及内置物断裂发生。结论后路颈椎板切除、植骨融合内固定治疗多节段脊髓型颈椎病伴节段不稳能够改善神经功能,减少轴性症状发生,恢复颈椎生理性前凸。更多还原

【Abstract】 Objective To evaluate the effect of posterior laminectomy and fusion with internal fixation for multilevel cervical spondylotic myelopathy accompanied with segmental instability. Methods Fifteen patients with multilevel cervical spondylotic myelopathy accompanied with cervical segmental instability underwent posterior laminectomy,decompression,fusion and internal fixation. The preoperative and postoperative data were analyzed by the JOA score,visual analogue scale( VAS),cervical lordosis angle( Cobb angle),cervical curvature index( CCI),and back shift distance of the spinal cord. Results Total 12 ~ 52 months were followed up in 15 patients. At the time of final follow-up,the JOA score,VSA,Cobb angle,CCI,and back shift distance of the spinal cord were improved; the differences were statistically significant( P < 0. 01). During the follow-up,one patient suffered incision infection and another patient experienced C5 nerve root palsy; there was no leakage of cerebrospinal fluid or instrument failure. Conclusions Posterior laminectomy and fusion with internal fixation for multilevel cervical spondylotic myelopathy accompanied with segmental instability is demonstrated to be an effective strategy for improving neurologic function,decreasing the incidence of axial symptoms,and restoring the normal cervical lordosis.更多还原