[1]杨峰,移平,唐向盛,等.微型钛板在颈椎后路单开门椎管扩大成形术中的临床疗效分析[J].中国中医骨伤科杂志,2017,25(09):25-29.
　YANG,Feng,YI,et al.Analysis of Clinical Efficacy of Titanium Miniplate in the Posterior Cervical Single Door Laminoplasty[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(09):25-29.
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微型钛板在颈椎后路单开门椎管扩大成形术中的临床疗效分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年09期
页码:
25-29
栏目:
临床研究
出版日期:
2017-09-08

文章信息/Info

Title:
Analysis of Clinical Efficacy of Titanium Miniplate in the Posterior Cervical Single Door Laminoplasty
文章编号:
1005-0205(2017)09-0025-05
作者:
杨峰1; 移平1; 唐向盛1; 谭明生1△; 郝庆英1; 刘楚吟1
1中日友好医院脊柱外科(北京,100029)
Author(s):
YANG; Feng1; YI; Ping1; TANG; Xiangsheng1; TAN; Mingsheng1△; HAO; Qingying1; LIU; Chuyin1
1China-Japan Friendship Hospital,Beijing 100029,China.
关键词:
颈椎病;  后路单开门椎管扩大成形术;  微型钛板;  内固定
Keywords:
cervical myelopathy;  posterior expansive open-door laminoplasty;  miniplate;  internal fixation
分类号:
R687.3
文献标志码:
A
摘要:
目的:探讨微型钛板在颈椎后路单开门椎管扩大成形术中的临床疗效。方法:2014年6月至2015年12月,本院收治多节段脊髓型颈椎病患者59例,均采取后路单开门手术,其中32例采用微型钛板固定术(微型钛板组),27例采用传统丝线悬吊法作为对照组(丝线悬吊组)。对比两组手术时间、术中出血、C5神经麻痹情况、轴性症状发生情况,并通过日本骨科协会(JOA)17分法对所有患者术前术后神经功能进行评分,计算神经功能改善率。随访过程中,测量并比较两组患者的颈椎曲度及椎板开门角度。结果:所有患者手术顺利,微型钛板组与丝线悬吊组在手术时间及术中出血量方面差异无统计学意义(P>0.05)。两组患者术后未出现伤口感染,均出现C5神经麻痹及轴性症状,后经对症治疗症状消失,但微型钛板组的C5神经麻痹及轴性症状的发生率明显低于丝线悬吊组,差异有统计学意义(P<0.05)。两组患者术后均随访6～18个月,两组患者末次随访时JOA评分较术前明显提高,差异有统计学意义(P<0.05),两组间的术前及术后JOA评分相比,差异无统计学意义(P>0.05)。两组的术前颈椎Cobb角差异无统计学意义(P>0.05),而末次随访时,微型钛板组的颈椎Cobb角大于丝线悬吊组,差异有统计学意义(P<0.05)。术后1周时,两组的开门角度差异无统计学意义(P>0.05),而末次随访时,微型钛板组的开门角度大于丝线悬吊组,差异有统计学意义(P<0.05)。结论:微型钛板在颈椎后路单开门扩大椎管成形术中能够充分减压,解除脊髓压迫,且操作简单,稳定性强,患者能够早期功能锻炼,减少了轴性症状、再关门等并发症的出现,是一种治疗多节段脊髓型颈椎病行之有效的方法。
Abstract:
Abstract Objective:To evaluate the clinical outcome of posterior expansive open-door laminoplasty with miniplate for multi-level cervical myelopathy.Methods:Between June 2014 and December 2015,a total of 59 patients with multi-level cervical myelopathy were included in the study.32 cases underwent posterior expansive open-door laminoplasty with miniplate(miniplate group),and 27 cases underwent conventional posterior expansive open-door laminoplasty with suture(suture group).Operation time,intraoperative blood loss,and complications including C5 nerve root palsy and axial symptoms of the two groups were recorded and compared.The Japanese Orthopaedic Association(JOA)score was used for neurological assessment.Cervical overall Cobb angle and open angle of two groups were recorded and compared.Results:All the patients underwent posterior expansive open-door laminoplasty successfully.There was no significant difference in operation time and intraoperative blood loss(P>0.05).No wound infection was noted in two groups.The miniplate group had significant lower rate of C5 nerve root palsy and axial symptoms than the suture group(P<0.05).All patients were followed up for 6～18 months.At the last follow-up,all patients had significant improvement in JOA scores(P<0.05).There were no significant differences in preoperative or postoperative JOA scores between two groups(P>0.05).There were no significant differences in preoperative cervical overall Cobb angle and open angle between two groups(P>0.05).However,the miniplate group had significant larger overall Cobb angle and open angle than the suture group at the last follow-up(P<0.05).Conclusion:Posterior expansive open-door laminoplasty with miniplate can result in sufficient neurological decompression for multi-level cervical myelopathy.This technique can reduce the incidence of axial symptoms,and prevent further closure of opened lamina.

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备注/Memo

备注/Memo:
1中日友好医院脊柱外科(北京,100029) △通信作者 E-mail:13911025605@163.com
更新日期/Last Update: 1900-01-01