单开门椎板成形术治疗脊髓型颈椎病的临床观察  

Clinical Studies of Expansive Open-door Laminoplasty for Cervical Spondylotic Myelopathy

作　　者：赵兵[1] 陈利江[1] 唐诗添[1] 王军[1] 

机构地区：[1]绵阳市中心医院脊柱外科,四川绵阳621000

出　　处：《川北医学院学报》2009年第1期19-22,共4页Journal of North Sichuan Medical College

摘　　要：目的评价单开门椎管成形术对脊髓型颈椎病的疗效。方法对37例脊髓型颈椎病患者行单开门椎管成形术,术前、术后采用日本骨科协会JOA评分评估临床疗效,颈椎过屈、过伸侧位X线片比较手术前后颈椎总的运动范围(ROM)及术后根性、轴性症状的发生率。结果术后平均随访18月(8-42月),术前JOA平均为(7.2±2.1)分,术后JOA评分为(13.7±3.5)分,改善率66.3%,颈椎总活动度较术前减小(12.6±3.4)°,术后有4例(10.8%)出现C5神经根麻痹,11例(29.7%)发生轴性症状。结论单开门椎管成形术能有效促进脊髓型颈椎病神经功能恢复,相当程度保留了颈椎运动范围,但其相关并发症也应引起重视。Objective To investigate the effects of posterior expansive open-door laminoplasty in the treatment of cervical spondylotic myelopathy （CSM）. Methods Thirty-seven patients with CSM confirmed by clinical appearance and images （X-ray, CT and/or MRI） were performed posterior unilateral open-door laminoplasty at the level of C3-C7 routinely. Neurological function （JOA scoring system） and dynamic lateral view X-rays of cervical spine were evaluated before and after operation. The palsy of nerve root and axial symptoms were observed. Results The average period of follow-up was 18 months. The pre-and post-operative JOA score were 7.2 ± 2.1 and 13.7 ± 3.5 respectively. The improvement rate was 66.3 %. The range of motion （ROM） of cervical spine was reduced by （ 12. 6 ± 3.4 ）°. The palsy of C5 nerve root occurred in 4 patients and axial symptom was observed in 11 patients after operation in this series. Conclusion The expansive open-door laminoplasty can improve the neurological function for CSM significantly and maintain the motion of the cervical spine to a great extent. The open-door laminoplasty can achieve satisfactory result. However, we should keep in mind about its complications.

关 键 词：颈椎病 椎板成型术 临床效果 

分 类 号：R681.5[医药卫生—骨科学]