微型支撑钛板在颈后路椎管扩大成形术中应用的疗效观察  

Comparison between the Efficacy of Titanium Miniplate Strutting and Traditional Suture Suspension in the Posterior Cervical Laminoplasty

作　　者：廖兴华[1] 黄晓魏[1] 李智[1] 冯梅[1] 张维成[1] 曹智全[1] 

机构地区：[1]广东省湛江中心人民医院,广东湛江524037

出　　处：《临床医学工程》2012年第10期1707-1709,共3页Clinical Medicine & Engineering

摘　　要：目的评价微型钛板支撑固定在颈后路椎管扩大成形术中应用的临床效果。方法自2007年5月至2011年5月，对采用后路单开门椎管扩大成形术治疗的34例脊髓型颈椎病患者进行回顾性分析，男20例，女14例，年龄21-70岁，平均57岁。其中17例应用SynthesArch微型钛板于开门侧支撑固定（研究组），另17例采用常规丝线悬吊固定（对照组）。所有患者均获随访，时间6-32个月，平均12个月。采用JOA评分及影像学资料对手术前后临床疗效进行评估，对术前、术后JOA评分、轴性症状以及再关门现象进行比较。结果术后随访时两组患者TOA评分均明显改善，术后卧床时间、轴性症状发生率方面研究组均明显低于对照组（P〈0．01），末次随访时研究组未见铁板失效及再关门现象，对照组开门角度有不同程度的丢失。结论微型钛板支撑固定法与传统丝线悬吊固定法相比，固定椎板更牢靠，避免了对椎旁肌和关节囊的刺激，术后可早期离床活动，不需颈围制动，明显减少轴性症状的发生，操作简单安全．临床效果更加满意。Objective To evaluate the clinical results of posterior cervical laminoplasty using titanium miniplate. Methods From May 2007 to May 2011, 34 patients were performed with posterior open-door posterior laminoplasty. 17 cases applied with strut miniplate were classified as study group while other 17 cases with tradtional method of suture suspension as control group. After operation, all cases were followed up for 6 months to 32 months （average 12 months）. Retrospective analysis of the imaging data and clinical results of these cases were taken. Results During follow-up, the JOA score improved obviously in the two groups while the periods of bed rest and immobilization and the incidence of axial symptoms in the study group were fewer than those in the controled group significantly （P 〈0.01）. At the final follow-up, no screw loosening and reclose of the opened laminae were observed in the study group, but the elevated angel of the laminae lose to certain extent in the control group. Conclusions Compared with traditional method of suture suspension, application of strut miniplate can get a more stable laminoplasty, a better clinical result and fewer axial symptoms.

关 键 词：微型钛板 支撑 颈椎管扩大成型 颈椎管狭窄 

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