改良颈椎管成形术治疗脊髓型颈椎病合并颈椎管狭窄  

The effect of the cervical laminoplasty without bone graft on hinge side and with early postoperative neck mobilization

作　　者：李新奎[1] 王哲[1] 罗卓荆[1] 陶惠人[1] 孟国林[1] 肖伟[1] 龚凯[1] 

机构地区：[1]第四军医大学西京医院骨科,陕西西安710032

出　　处：《临床骨科杂志》2009年第2期127-129,共3页Journal of Clinical Orthopaedics

摘　　要：目的评价改良颈椎管成形术治疗脊髓性颈椎病合并颈椎管狭窄的效果。方法采用改良颈椎管成形术(即门轴侧不植骨,术后颈围固定时间缩短为4～6周)治疗67例脊髓型颈椎病患者,对其中38例资料完整者根据术前、术后随访的X线平片,计算机辅助下测量颈椎的活动度与稳定性。结果38例获得随访,时间6～51(26.8±3.0)个月。按JOA评分:术后改善率为54.6%,术后轴性症状发生率明显下降;术前平均颈椎活动度为(37.1±10.6)°,术后颈椎活动度较术前活动度平均减少(27±5)%,稳定性良好。结论改良颈椎管成形术治疗脊髓性颈椎病合并颈椎管狭窄临床效果良好。Objective To analyze the clinical outcome of cervical laminoplasty without bone graft on binge side. Methods 68 patients with cervical spondylotic myelopathy underwent modified en bloc laminoplasty without bone graft on hinge side who had postoperative 4 - 6 weeks neck immobilization with a collar were the subject of this study. According to the method of Penning, the CROM was measured. Results The follow-up period ranged from 6 to 51 （26. 8 ± 3.0） months. After laminoplasty, no patient showed neurological deterioration and cervical instability due to early neck mobilization and no bone graft on hinge side. The average recovery rate was 54. 6%. The average preoperative CROM was 37. 1° ± 10. 6°. The CROM was decreased 27% ± 5% in the follow-up. There was lower rate of axial symptoms after operation. Conclusions Cervical laminoplasty without bone graft on hinge side and the early mobilization of the neck after surgery provide satisfactory results.

关 键 词：脊髓型颈椎病 颈椎管成形术 颈肩痛 椎管狭窄 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]