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华西医学  2015 

颈前路椎间盘切除椎间融合术治疗颈椎病体会

DOI: 10.7507/1002-0179.20150247, PP. 855-858

Keywords: 颈前路椎间盘切除椎间融合术,颈椎病,手术,体会

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Abstract:

目的?探讨颈前路椎间盘切除椎间融合术(ACDF)治疗颈椎病的手术指征及优点。方法?回顾性分析2010年1月-2013年10月采用ACDF治疗颈椎病且获得随访的患者36例。结合患者术前术后影像学资料,日本骨科协会(JOA)评分等资料分析。结果?36例患者获得随访6~25个月,平均16个月,JOA评分术前平均(10.67±2.66)分,术后3个月平均(13.47±2.06)分,术后6个月平均(14.11±1.56)分,术后12个月平均(14.97±1.78)分。术中患者均未出现脊髓神经损伤,无食道、气管损伤,无喉上神经喉返神经损伤。术后吞咽困难明显减轻时间为3~5d者8例,5~7d者6例,3周者10例,1个月后36例患者吞咽困难全部消失。随访期间无患者出现钛网下沉、移位或钛板断裂。结论?ACDF适用于解除退变的椎间盘对脊髓和(或)神经根的压迫,尤其适用于不伴有僵硬性后凸畸形,不伴有多节段后纵韧带骨化,且对脊髓的压迫位于椎间盘平面而非椎体平面的颈椎病。只要严格掌握指征,其疗效确切,顽固性颈痛消失快,对脊柱稳定性干扰少,愈合快。有利于减少术后并发症的发生,是颈椎前路经典手术方式。

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