颈椎管扩大术的应用解剖及临床研究  

Applied Anatomic and Clinical Studieson Cervical Laminoplasty

作　　者：李甲振[1] 孔抗美[1] 齐伟力[1] 王卫东[1] 

机构地区：[1]河南医科大学第一附属医院骨科

出　　处：《河南医学研究》1998年第3期237-239,共3页Henan Medical Research

摘　　要：目的：观察颈椎不同位置时椎管内结构的变化，为临床颈椎后路手术体位的改进提供客观依据。方法：测量８具成人颈椎标本在不同位置时颈椎矢状径及截面积的变化。在自然屈颈位，对８７例颈椎管狭窄症患者行颈椎管扩大术及椎板间植骨融合，随访１～４年，按ＪＯＡ标准评定疗效。结果：颈椎轻度屈曲时，对椎管容积影响不大，中立位和自然屈颈位时椎管矢状径和截面积两者均无明显差异（Ｐ＞００５）。临床８７例患者中，优２７例，良４１例，改进１６例，无变化３例，有效率为９６５％。结论：颈椎后路椎管扩大术，坐位值得推荐。行椎板间植骨融合，可使扩大的椎管达到牢固的骨性融合，防止椎板塌陷。Objective: To observe the changes in the structure of the intravertebral canal in different position and improve patient's operating position on cervical laminoplasty. Methods:Changes of the sagittal diameter and the cross-section area on 8 cervical vertbral specimens were measured in different positions. 87 patients in sitting position were treated with bone grafting between the vertebral lamine in the operation of cervical laminoplasty. The follow-up study was carried out for 1 to 4 years. The result was evaluated with the criterion of JOA. Results:There were no significant difference (P>0.05) between the sagittal diameter and the cross-section of the vertebral canal in the natural position of the vertebral canal and those at mild flexion. There were 27 excellent cases, 41 good, 16 improved and 3 poor. The average rate of improvment was 96.5%. Conclusion: Sitting position is recommendable to the operation of laminoplasty for cervical stenosis. Using the bone grafting between the vertebral laminae to obtain the stable bony union in the enlarged vertebral canalCollapse of the vetebral laminae was prevented. 

关 键 词：颈椎 矢状径 截面积 解剖学 治疗 外科手术 

分 类 号：R681.55[医药卫生—骨科学]