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脊髓型颈椎病手术治疗的远期疗效 |
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贾连顺 袁文 倪斌 陈雄生 陈德玉
【摘要】目的研究脊髓型颈椎病经手术治疗的远期疗效及影响疗效的因素。方法报告185例脊髓型颈椎病，对发病因素、病程及影像学表现特征进行分析。全部实施颈前路减压及自体髂骨移植融合术，其中25例于术后6个月～2年再次手术。术后随访5年6个月～15年，平均6年7个月。结果功能评价：优89例(48.1％)、良57例(30.8％)、可28例(15.1％)及差11例(6.0％)。根据40分评分法，平均提高8.5分，其中36～40分79例，31～36分45例。提示病程长短与疗效相关，病程在6个月内的患者疗效优于1年以上者(P＜0.01).结论 脊髓型颈椎病手术治疗远期效果是肯定的;手术时机\病理变化程度及手术技术等对治疗效果有明显影响.
【关键词】颈椎 脊髓压迫症 外科手术 治疗结果
Long-term Results of Surgical Treatment of Cervical Spondylotic Myelopathy
JIA Lianshun,YUAN Wen,NI Bin,et al.
Department of Orthopaedics,Changzheng Hospital,Second Military Medical University,Shanghai 200003
【 Abstract】 Objective To observe the long term results and its relative factors of surgical treatment of cervical spondylotic myelopathy (CSM). Methods One hundred and eighty-five cases of CSM were reviewed. The pathogenesis, history and characteristics on imaging were analyzed. All were treated with anterior cervical decompression and fusion with autogenous iliac bone graft. Twenty-five cases had revision surgery 6 months to 2 years after the initial operation. Results Functional evaluation revealed excellent in 89 cases (48.1％ ), good in 57 cases (30.8％ ), fair in 28 cases (15.1％ ) and poor in 11 cases (6.0％ ). According to 40 points score method, the average improvement was 8.5 point. Of these, 79 cases were between 36 to 40 points. Forty-five cases were between 31 to 36 points. It was found that the duration of illness played the main role in the final outcome. Those with history of illness of less than 6 months had better results than the cases with history of more than 1 year (P＜0.01).Conclusions The long-term results of surgical treatment of CSM can be confirmed. The timing of operation,degree of pathology and the surgical techniques sre the important factors for a better outcome of the surgical treatment of CSM.
【Key words】 Cervical vertebrae Spinal cord compression Surgery,operative Treatment outcome
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