应用珊瑚人工骨为间隔物治疗退行性颈椎管狭窄症  

Longitudinal spinous splitting laminoplasty with coral bone for cervical stenosis

作　　者：刘波[1] 田伟[1] 茅剑平[1] 李勤[1] 何达[1] 肖斌[1] 

机构地区：[1]北京积水潭医院脊柱外科,100035

出　　处：《中华医学杂志》2012年第5期292-295,共4页National Medical Journal of China

摘　　要：目的 探讨应用珊瑚人工骨作为间隔物行棘突纵割式颈椎椎管扩大成形术的效果.方法 随访1995年8月至2003年12月北京积水潭医院脊柱外科142例传统应用珊瑚人工骨作为间隔物手术和147例保留颈2和颈7棘突肌肉止点的应用珊瑚人工骨作为间隔物手术做至少3个月的随访,通过回顾性研究对临床效果、颈椎曲度、合并症、颈椎活动度、手术时间和失血量作对比研究所有的统计数据采用SPSS 13.0进行相关性分析.结果 两组手术在临床效果和出血量没有显著性差异,改良组在手术时间减少（t =2.56,P＜0.05独立样本t检验）,颈椎生理曲度和颈椎活动度保持更好（t=-2.314,P＜0.05）,颈椎手术后的轴性症状发生率低（t=-2.314,P＜0.05）.结论 在颈椎后路手术中,减少肌肉损害能够降低手术并发症.保留主要肌肉止点可以使颈椎保持良好的生理曲度,减少轴性症状的发生率.Objective To explore the outcomes of longitudinal spinous splitting laminoplasty with coral bone （abbreviated as SLAC） for cervical stenosis.Methods A total of 142 patients underwent conventional SLAC while 147 other patients modified SLAC.Assessments were made at pre-operation,postoperation and 3-month follow-up to examine the effects of two surgical approaches on the recovery rate of JOA （Japanese Orthopedic Association） score.The change of cervical alignment,change of cervical motions,axial syndrome,operative duration and intra-operative blood loss were recorded and analyzed with SPSS 13.0.Results No significant difference existed between two groups in the recovery rate of JOA score and intra-operative blood loss.The smaller change of cervical alignment and change of cervical motions were found in the modified SLAC group.The modified SLAC group had fewer patients with axial syndrome during the follow-up period. The operative duration was shorter in the modified SLAC group. Conclusion Preventing muscle injuries in cervical laminoplasty can reduce the incidence of complications.The modified SLAG approach may protect cervical posterior extensor musculature,maintain the cervical lordotic alignment and reduce the incidence of post-operative axial syndrome.

关 键 词：椎管狭窄 颈椎 外科手术 手术中并发症 

分 类 号：R687.3[医药卫生—骨科学]