孙程帅，李雷，孟伟宁（中国医科大学附属盛京医院脊柱外科，辽宁　沈阳110004）

颈椎后路椎弓根螺钉内固定术治疗脊髓型颈椎病患者的疗效分析

孙程帅，李雷*，孟伟宁
（中国医科大学附属盛京医院脊柱外科，辽宁沈阳110004）

目的：探讨颈椎后路椎弓根螺钉内固定术治疗脊髓型颈椎病患者的疗效。方法：选择2014年3月至2015年9月我科同一医师手术治疗的脊髓型颈椎病患者55例，均行颈椎后路椎弓根螺钉内固定术。术后及随访复查颈椎三维CT并测量患者术后颈椎曲度，通过JOA评分及改善率、NDI评分以及VAS评分评估患者神经功能恢复情况，并进行统计学分析。结果：55例患者术后颈椎曲度、JOA评分、NDI评分、VAS评分均明显优于术前（P＜0.05）。所有患者都获得了随访，随访时间6～24个月，平均14个月。末次随访时，颈椎曲度与术后比较差异无统计学意义（P＞0.05），JOA评分、NDI评分、VAS评分与术后比较差异有统计学意义（P＜0.05）。结论：颈椎后路椎弓根螺钉内固定术能有效改善脊髓型颈椎病患者术前颈椎曲度不良及神经功能。

脊髓型颈椎病；后入路；椎弓根螺钉；颈椎曲度；神经功能

doi：10.16753/j.cnki.1008-2344.2016.04.006

［Abstract］Objective：To evaluate the clinical effect of posterior cervical pedicle screw fixation operation for cervical spondylotic myelopathy.Methods：From Mar 2014 to Sep 2015，55 patients with cervical spondylotic myelopathy treated with posterior cervical pedicle screw fixation operation were involved.Cervical curvature in the cervical three dimensional CT by the Harrison's cervical curvature measuring method was measured，and JOA scores，NDI scores and VAS scores before and after operation and the last follow-up were evaluated.Results：A total of 55 patients with cervical spondylotic myelopathy obtained good operation effect and the cervical curvature and neural function were improved.The cervical curvature，JOA score，NDI scores，and VAS scores were significantly better than that before operation（P＜0.05）.Last follow-up results showed that there was statistical significance on JOA score，NDI score，and VAS score compared with that after operation（P＜0.05），but not on cervical curvature（P＞0.05）. Conclusion：The neurological function and cervical curvature of the cervical spondylotic myelopathy can be improved through posterior cervical pedicle screw fixation operation.

［Key words］cervical spondylotic myelopathy；posterior approach；pedicle screw；cervical curvature；nerve function

脊髓型颈椎病是脊柱外科常见的退行性疾病，严重影响人们的生活质量。随着我国人口老龄化的比例逐渐增高，其发病率也逐年上升。近年来的研究发现，随着生活习惯和工作环境的不断变化，颈椎病患病率呈低龄化趋势，考虑与不良姿势、过度疲劳、情绪紧张、外伤等有关。严重的脊髓型颈椎病需要手术治疗，其中根据手术入路不同，颈椎手术分为前路、后路和前后路联合手术。……