锚定法单开门椎管成形术对术后轴性症状和颈椎曲度影响的病例对照研究  

The comparative study of effect of a modified open door laminoplasty using anchor method on axial symptoms and cervical curvature

作　　者：张学利[1] 王善金[1] 王云力[1] 刘献强[1] 

机构地区：[1]天津市人民医院脊柱外科,天津300121

出　　处：《中国骨伤》2008年第10期759-761,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:观察评价锚定法单开门椎管成形术在降低术后轴性症状发生和减少颈椎曲度丢失中的作用。方法:选择2004年10月至2007年5月行锚定法单开门椎管成形术并获得完整随访的患者56例(锚定单开门,A组),与50例同期行传统单开门手术的患者(传统单开门,B组)进行对比分析,记录手术时间、术中出血量、轴性症状及JOA(17分法)评分,根据X线片测量C2与C7椎体后壁切线夹角α。结果:手术时间:A组(116.0±27.9)min,B组(120.0±18.9)min,差异无统计学意义(P>0.05);术中出血量:A组(148.0±68.3)ml,B组(152.0±63.4)ml,差异无统计学意义(P>0.05);A组23例(41.1%)发生轴性症状或加重,B组38例(76.0%)发生轴性症状或加重,差异有统计学意义(P<0.05);JOA评分:A组改善率(61.1±24.5)%,B组改善率(53.3±23.3)%,差异有统计学意义(P<0.05);A组术前颈曲夹角(6.3°±5.1°)与术后颈曲夹角(6.6°±4.5°)比较无统计学意义(P>0.05),B组术前颈曲夹角(5.9°±5.1°)与术后颈曲夹角(4.8°±3.5°)比较有统计学意义(P<0.05)。结论:锚定法单开门椎管成形术能减少术后轴性症状的发生和颈椎曲度的丢失,有利于早期功能锻炼,能提高脊髓型颈椎病的治疗效果。Objective：To evaluate the effect of a modified open door laminoplasty using anchor method on reducing the occurrence of axial symptoms and loss of cervical curvature. Methods：From October 2004 to May 2007,56 patients with cervical spondylotic myelopathy underwent this procedure and been followed up （group A）. Another 50 patients who underwent conventional unilaterally open-door laminoplasty served as control （group B）. The operation time, blood loss,JOA scores and the incidence of newly developed or deteriorated axial symptoms were recorded. Preoperative and postoperative curvature angle which was presented on the tangent of posterior vertebral body margins of C2 and C7 in the cervical spine were measured on cervical radiographs. Results：The operative time was （116_±27.9） min in group A and （120± 18.9） min in group B,showing no statistically significant difference （P〉0.05）. The operative blood loss was （148±68.3） ml in group A and （152±63.4） ml in group B （P〉0.05）. According to JOA scores,the average recovery rates were （61.1 ±24.5 ）% in group A and （53.3±23.3）% in group B （P〈0.05）. Postoperative development or deterioration of axial symptoms occurred in 41.1% of patients in group A and 76.0% of patients in group B, showing statistically significant difference （P〈0.05）. There was no significant difference between preoperative （6.3°±5.1° ）and postoperative （6.60°±4.5°） cervical curvature angle in group A, whereas the mean value of postop- erative angle （4.8°±3.5° ）was significantly smaller than that of preoperative one （5.9°±5.1° ） in group B （P〈0.05）. Conclusion ： The modified open door laminoplasty using anchor method was effective on reducing the occurrence of axial symptoms and loss of cervical curvature and to the benefit of early functional training.

关 键 词：颈椎病 椎管成形术 轴性症状 颈椎曲度 

分 类 号：R681.55[医药卫生—骨科学] R681.5[医药卫生—外科学]