两种颈后路单开门手术方法对颈椎曲度指数及活动度的影响  

Clinical effect of two posterior single open-door laminoplasty on cervical curvature index and ranges of neck motion

作　　者：孔凡磊[1] 申勇[2] 聂志红[1] 刘中坡[1] 纪江峰[1] 侯市宾[1] 

机构地区：[1]河北省邢台市人民医院脊柱骨科,054031 [2]河北医科大学第三医院,石家庄市050051

出　　处：《中国矫形外科杂志》2012年第11期975-977,共3页Orthopedic Journal of China

基　　金：邢台市科研项目(编号:2012ZC088)

摘　　要：[目的]探讨两种颈后路单开门手术方法对术后患者神经功能改善率、颈椎曲度指数、颈椎活动度的影响及其临床意义。[方法]自2008年6月～2011年9月,78例脊髓型颈椎病患者接受颈后路单开门椎管扩大成形术。A组41例患者行改良术式,即保留颈半棘肌肌止,切除C3椎板,C4～7"锚定法"单开门椎管扩大成形术。B组37例患者行传统C3～7单开门椎管成形术。计算两组患者神经功能改善率及术前术后颈椎曲度指数、颈椎活动度的变化,研究两组间差异。[结果]两组患者术后神经功能改善恢复率,A组为(57.5±19.4)%,B组为56.3±19.8%,两组间差异无统计学意义,术后颈椎曲度指数丢失百分比,A组丢失(2.86±2.44)%,B组丢失(5.31±2.12)%,B患者手术前后颈椎曲度指数丢失明显多于A组。术后颈椎活动度,A组患者术后丢失(8.27±5.03)°,B组患者术后丢失(11.06±6.97)°,两组差异有统计学意义(P<0.01)。[结论]保留颈半棘肌肌止,C3椎板切除,C4～7"锚定法"单开门椎管扩大椎管成形术,与传统术式相比具有同样的神经功能改善率,同时能有效防止颈椎曲度指数及颈椎活动度的丢失。[Objective]To discuss clinical effect of two posterior single open-door laminoplasty on cervical curvature index and movement of the cervical spine.[Methods]Since June 2008 to September 2011,41 patients underwent extensive open-door laminoplasty,as reserved insertion of musculus semispinalis cervicis with C3 laminectomy and C4-7 modified open-door laminoplasty using ＂anchoring metlaod＂（Group A）,37 patients underwent conventional C3-7 open-door laminoplasty（Group B）.Preoperative and postoperative improvement rate of Japanese Orthopedic Association（JOA） scores,ranges of neck motion,cervical curvature indices were recorded and compared.[Results]The average of JOA improvement rate were（57.5±19.4）% for group A,and（56.3±19.8）% for group B.There was no significant difference in JOA improvement rate between two groups.Loss of cervical curvature indices were（2.86±2.44）% in group A and（5.31±2.12）% in group B,and the difference was statistically significant（P〈0.01）.Loss of ranges of neck motion were（8.27± 5.03）° in group A and（11.06±6.97）° in group B,significant difference was also seen（P〈0.01）.[Conclusion]Compared with the conventional operation,C3 laminectomy and C4-7 modified open-door laminoplasty using ＂anchoring method＂ is effective in preventing the loss of cervical curvature index and movement of the cervical spine,with adequate decompression of the spinal cord.

关 键 词：颈椎病 颈椎曲度指数 椎管扩大成形术 颈半棘肌 

分 类 号：R687.3[医药卫生—骨科学]