摘要目的 探讨Ⅰ期后前路减压、植骨固定术治疗严重下颈椎椎管骨性狭窄的临床疗效。方法 2006年4月- 2009年3月采取Ⅰ期后路减压、前路减压植骨固定术治疗严重下颈椎椎管骨性狭窄患者29例，其中颈椎陈旧性骨折11例，颈椎后纵韧带钙化7例，颈椎间盘突出钙化11例。病程2个月～3.2年，平均1.4年。术前神经功能按Frankel分级：B级2例，C级19例，D级8例；日本骨科学会( JOA)术前平均评分为9.8分。结果 本组患者随访7～28个月，平均15.2个月。植骨块于术后5个月骨性融合，融合率为100％。所有患者Frankel分级平均提高1.2级，神经症状均有明显减轻。JOA脊髓功能术后平均评分为13.8分，平均提高4.0分，平均改善率为55.6％。结论 Ⅰ期后前路减压、植骨固定术是治疗严重颈椎管骨性狭窄的安全有效的方法，术中可进行电生理监护以提高手术的安全性。

abstractsObjective To explore the clinical outcome of one stage posteroanterior decompression and bone implant in the treatment of severe lower cervical spinal bony canal stenosis. Methods The study involved 29 patients with severe lower cervical spinal bony canal stenosis treated with one stage posteroanterior decompression and bone implant from April 2006 to March 2009. There were 11 patients with old fractures, seven with posterior longitudinal ligament ossification and 11 with cervical disc calcification. The course of disease ranged from 2 months to 3.2 years, average 1.4 years. The nerve function was rated as grade B in two patients, grade C in 19 and grade D in eight according to Frankel scale. The average Japanese Orthopaedic Association (JOA) score was 9.8. Results All patients were followed up for 7-28 months (average 15.2 months), which showed bony fusion five months after operation, with fusion rate of 100％. The Frankel grade was increased for average 1.2 grades and the nervous symptoms alleviated remarkably. Mean postoperative JOA score was 13.8 and increased for mean 4.0, with mean amehoration rate of 55.6％. Conclusions One stage posteroanterior decompression and bone implant is a safe and effective method for treatment of lower cervical spinal bony canal stenosis, when the intraoperative electrophysiological monitoring can assure the operative safety.