下载文档原格式
颈前路椎体次全切除联合椎间隙减压融合内固定治疗多节段颈椎病谢纪宝;郑永茂;徐秀成;郭永杰;柴充;王浩磊【期刊名称】《临床骨科杂志》【年(卷),期】2017(20)5【摘要】目的探讨颈前路椎体次全切除联合椎间隙减压融合内固定术治疗多节段颈椎病的疗效.方法对26例多节段颈椎病的患者采用颈前路椎体次全切除联合椎间隙减压融合内固定术治疗,观察手术并发症情况及术后1周及6、12个月的JOA 评分,并用Epstein标准评价临床症状改善情况.结果患者均获得随访,时间24个月.1例术后6h出现颈部血肿,2例出现喉返神经牵拉伤并发症.术后1周及6、12个月时JOA评分均较术前明显提高(P＜0.05).术后12个月临床症状改善情况为:优6例,良16例,中4例.22例对手术结果满意.术后2年25例骨性融合,1例(3节段者)1个间隙不融合,但患者无临床症状.结论颈前路椎体次全切除联合椎间隙减压融合内固定术是治疗多节段颈椎病安全、有效的方法.%Objective To investigate the clinical outcomes of anterior cervical corpectomy and fusion combined with anterior cervical discectomy and fusion for treatment of multilevel cervical spondylosis.Methods A total of 26 consecutive patients with multilevel cervical spondylosis undergone anterior cervical corpectomy and fusion combined with anterior cervical discectomy and fusion were retrospectively reviewed.The operation complications and the JOA score of postoperative intervals of 1 week and 6,12 months were recorded and assessed respectively,and the neurofunctional improvement were assessedand recorded by Epstein standard.Results All cases were regularly followed up for 24 months.One case came out neck hematomas in 6 h and 2 cases came out injury of recurrent laryngeal nerve after operation.The JOA scores significantly improved at 1 week and 6,12 months after operation(P ＜ 0.05).At 12 months after operation,the neurofunctional improvement were excellent in 6 patients,good in 16,fair in 4.Twenty-two cases gained satisfactory results of surgery.The 25 cases got solid fusion in two years after operation.1 intervertebral space of 1 case(3 segments) was not fused,but the patient had no clinical symptoms.Conclusions Anterior cervical corpectomy and fusion combined with anterior cervical discectomy and fusion is safe and effective for treatment of multilevel cervical spondylosis.【总页数】3页(P520-522)【作者】谢纪宝;郑永茂;徐秀成;郭永杰;柴充;王浩磊【作者单位】平煤神马医疗集团总医院骨科,河南平顶山467000;平煤神马医疗集团总医院骨科,河南平顶山467000;平煤神马医疗集团总医院骨科,河南平顶山467000;平煤神马医疗集团总医院骨科,河南平顶山467000;平煤神马医疗集团总医院骨科,河南平顶山467000;平煤神马医疗集团总医院骨科,河南平顶山467000【正文语种】中文【中图分类】R681.5;R687.3【相关文献】1.颈前路椎体次全切除联合椎间隙减压融合治疗多节段脊髓型颈椎病 [J], 黄凯;常步青;于潮将;高啸;蒋允昌;冯虎2.颈前路经椎间隙减压加单椎体次全切除术治疗多节段颈椎病的疗效分析 [J], 陈为民;章筛林;石志才3.颈前路椎体次全切除减压联合椎间盘切除减压治疗多节段颈椎病合并颈椎过伸性损伤 [J], 孙敬国;黄科宇4.颈前路椎间隙减压联合椎体次全切除术治疗三节段脊髓型颈椎病效果观察 [J], 张德生5.颈前路椎间隙减压联合椎体次全切除术治疗三节段脊髓型颈椎病效果观察 [J], 李少华因版权原因，仅展示原文概要，查看原文内容请购买。
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发表时间：2016-06-21T11:36:18.890Z 来源：《医药前沿》2016年5月第14期作者：黄超李光富[导读] 脊髓性颈椎病是颈椎性疾病中比较严重的一种类型，尤其时多节段脊髓颈椎病会累计多个椎体节段。
黄超李光富（湖北省来凤县人民医院骨外科湖北恩施 445700）【摘要】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临床效果。
方法：选取我院自2012年5月～2015年5月间共救治的42例多节段脊髓型颈椎病患者作为研究对象，均采用颈椎前路多节段椎体次全切减压植骨融合内固定手术进行治疗，对比该组患者治疗前后的的颈椎曲度C值和JOA评分情况。
结果：手术治疗后平均随访1年，患者的JOA评分为（15.0±0.1），与治疗前的数据对比差异具有统计学意义，P＜0.05;并发症发生率为4.76%。
结论：在治疗多节段脊髓型颈椎病时采用颈椎前路多节段椎体次全切减压植骨联合内固定术治疗效果显著，非常值得临床上推广使用。
【关键词】多节段脊髓型颈椎病；多节段椎体次全切减压植骨手术；内固定手术【中图分类号】R615 【文献标识码】A 【文章编号】2095-1752（2016）14-0143-02 脊髓性颈椎病是颈椎性疾病中比较严重的一种类型，尤其时多节段脊髓颈椎病会累计多个椎体节段，导致椎体压迫颈髓造成神经功能损伤的情况[1]。
患者主要的临床症状为躯体感觉严重减退、上肢和下肢均有麻木和无力感[2]。
该种疾病已经发现应该立即采取有效措施进行治疗，负责将会导致患者发生严重并发症严重者甚至出现截瘫的情况。
临床治疗中手术入路途径的选择存在较大的差异，为了研究哪种手术入路的效果更好我院进行长期的实验研究，现将实验的结果报告如下：1.资料与方法1.1 一般资料本次实验的所有研究对象均是我院近几年收治的多节段脊髓型颈椎病患者，共计病例数为42例，年龄最小的45岁，年龄最大的患者67岁，年龄中数为（57.3±1.4）岁，病程时间在0.5～4年之间，病程中数为（2.3±0.2）年；其中病变节段为3个的患者32例，病变节段为4个的患者10例，霍夫曼征单侧呈阳性患者12例，双侧均呈阳性患者30例。
前路椎间盘切除减压融合与椎体次全切除减压融合治疗多节段颈椎病疗效比较吴畏;朱天亮【期刊名称】《临床骨科杂志》【年(卷),期】2014(000)005【摘要】目的：比较前路椎间盘减压融合( ACDF)与前路椎体次全切除减压融合( ACCF)治疗多节段颈椎病的效果。
方法将138例多节段脊髓型颈椎病患者按照治疗方式的不同分为观察组(行ACDF治疗)和对照组(行ACCF治疗),比较两组手术时间、术中出血量、术后住院时间、术前与术后6个月颈椎总活动度、颈椎曲度、颈椎节段性高度及JOA评分。
结果手术时间：观察组(128．3±32．4)min,对照组(163．2±43．6)min；术中出血量：观察组(161．4±122．5)ml,对照组(319．2±308．7)ml；以上指标观察组均少于对照组(P<0．05)。
术后住院时间：观察组(8．1±3．6)d,对照组(9．5±4．2)d；术后6个月时JOA评分：观察组(12．1±2．2)分,对照组(11．7±2．1)分；颈椎总活动度：观察组26．6°±7．3°,对照组30．5°±8．1°；以上指标两组间差异无统计学意义(P>0．05)。
术后颈椎曲度：观察组23．5°±7．4°,对照组16．1°±7．2°；椎间节段性高度：观察组5．6°±0．4°,对照组4．7°±0．8°；以上指标两组比较差异有统计学意义(P<0．05)。
结论 ACDF较ACCF手术时间短、术中出血量少、颈椎生理弯曲和椎间节段高度恢复更好。
%Objective To compare the clinical efficacy of anterior cervical discectomy and fusion ( ACDF) and ante-rior cervical corpectomy and fusion ( ACCF) . Methods In order to provide reference for the treatment of multi-seg-mental cervical spondylotic myelopathy,138cases of patients with multi-segmental cervical spondylotic myelopathy were divided into observation group and control group by different ways of treatment. The observation group received ACDF treatment, the control group received ACCF treatment. Compared the efficacy difference between the two groups in operation time, intraoperative blood soss, postoperative hospital stay,the cervical over-flexion and tablets activity,the cervical vertebrae physiology curvature,the heights of the cervical intervertebral space were followed up for 6 months preoperatively and 6 months postoperatively. And used the Japanese Orthopaedic Association scoring sys-tem(JOA) to evaluate the therapeutic effect. Results Operationtime:observation group was (128. 3 ± 32. 4) min, the control groupwas(163. 2 ± 43. 6) min; blood loss: the observation group was(161. 4 ± 122. 5) ml, the control group was (319. 2 ± 308. 7) ml; observation group were all less than the control group (P<0. 05). Postoperative hospital stay:observation grou p was (8. 1 ± 3. 6) d, the control group was (9. 5 ± 4.2) d;postoperative 6 months, JOA result:observation group was (12. 1 ± 2.2) points, the control group was (11. 7 ± 2. 1) points; cervical total activity :observation group was 26. 6° ± 7. 3°, the control group was 30. 5 ° ± 8. 1°, among the above indicators there was no statistically significant differences ( P>0. 05 ) . Postoperative cervical curvature: the observation group was 23. 5° ± 7. 4°, the control group was 16. 1° ± 7. 2°;intervertebral segm ental height:observation group was 5. 6° ± 0. 4°, the control group was 4. 7° ± 0. 8°; between these indicators there were statistically significant differences between groups ( P <0. 05 ) . Conclusions Comparedwith ACCF, ACDF has shorter operative time, less blood loss, cervical physiological curvature and height of intervertebral segment recovered well, but there is no statistically significant differences on postoperative hospital stay time, postoperative JOA score and cervical total activity.【总页数】4页(P497-500)【作者】吴畏;朱天亮【作者单位】重庆市红十字会医院重庆市江北区人民医院骨科，重庆 400020;重庆市第三人民医院骨科，重庆 400014【正文语种】中文【中图分类】R681.53;R687.3【相关文献】1.颈前路椎体次全切除联合椎间隙减压融合内固定治疗多节段颈椎病 [J], 谢纪宝;郑永茂;徐秀成;郭永杰;柴充;王浩磊2.颈前路椎体次全切除减压联合椎间盘切除减压治疗多节段颈椎病合并颈椎过伸性损伤 [J], 孙敬国;黄科宇3.颈前路减压+MC+®颈椎融合器植骨融合与椎体次全切除融合钛板置入内固定治疗单节段脊髓型颈椎病对比观察 [J], 杨子斌;赵伟;吕乔;董锡亮4.颈前路减压+MC+(r)颈椎融合器植骨融合与椎体次全切除融合钛板置入内固定治疗单节段脊髓型颈椎病的比较 [J], 何斌;范磊;成伟男;王云华;王伯尧;刘军;黄野5.颈椎前路行椎间盘切除减压融合术与椎体次全切除减压融合术治疗老年脊髓型颈椎病的效果 [J], 柴燕武;于宪贵;沈广荣因版权原因，仅展示原文概要，查看原文内容请购买。
