一期颈腰椎联合手术治疗脊髓型颈椎病合并腰椎管狭窄症的临床疗效观察

摘要

Background:There are a certain number of patients having cervical and lumbar compression simultaneously and surgical procedures are still controversial for these patients.Objective:To explore the clinical effect of one-staged cervical and lumbar decompression operation on cervical spondylosis myelopathy (CSM) complicated with lumbar spinal stenosis (LSS).Methods:Clinical data of 38 patients with the diagnosis of CSM and LSS undergoing one-staged cervical and lum-bar decompression operation between June 2008 and June 2013 were retrospectively analyzed.The clinical outcomes of one-staged cervical and lumbar decompression operation were evaluated by the comparison of JOA scores for cervical vertebra and ODI scores for lumbar between pre-operation and post-operation.All the complications about operation were recorded. Results:The mean follow-up period of all patients was 22 months.The mean cervical JOA score was(6.9±2.7)before opera-tion and (14.6±1.9) after operation, and the difference was statistically significant (P<0.05); the mean lumbar ODI score was(0.7±0.1)before operation and(0.2±0.1)after operation,and the difference was statistically significant(P<0.05).One p-atient had dural injury during operation,one patient had cervical wound infection after operation,and two patients had C5 nerve root palsy.Conclusions:One-staged cervical and lumbar decompression operation has a good clinical effect on CSM associated with LSS.%背景:颈椎和腰椎同时因压迫产生相应症状的病例在临床中有一定发生率,对于此类患者外科手术的治疗方式目前仍存在一定争议.目的:探讨一期颈腰椎联合手术治疗脊髓型颈椎病合并腰椎管狭窄症的临床效果.方法:回顾分析我科自2008年6月至2013年6月诊断为脊髓型颈椎病合并腰椎管狭窄症并接受一期颈腰椎联合手术治疗的38例患者的病例资料,采用JOA颈椎评分和腰椎ODI评分量表比较颈腰椎患者手术前后临床疗效,并记录患者手术的相关并发症.结果:38例患者平均随访时间22个月.术前颈椎平均JOA评分为(6.9±2.7)分,术后(14.6±1.9)分,差异有统计学意义(P<0.05);术前腰椎平均ODI评分为(0.7±0.1)分,术后(0.2±0.1)分,差异有统计学意义(P<0.05).并发症包括术中硬膜损伤1例,术后颈部伤口感染1例,术后C5神经根麻痹2例.结论:一期颈腰椎联合手术治疗脊髓型颈椎病合并腰椎管狭窄症具有较好的临床疗效.