新型改良单开门椎管扩大成形术的临床应用研究  

Clinical study about modified open-door laminoplasty

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

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

出　　处：《中国现代医学杂志》2012年第29期87-90,共4页China Journal of Modern Medicine

基　　金：邢台市科技支撑计划项目(No:2012ZC088)

摘　　要：目的探讨保留颈半棘肌肌止,颈3椎板切除,颈4～7"锚定法"单开门椎管扩大椎管成形术,与传统术式相比是否具有同样的脊髓减压效果及减少患者术后轴性症状的发生。方法 2008年9月～2010年12月,28例脊髓型颈椎病患者接受改良单开门椎管扩大成形术(A组),25例患者行传统颈3～7单开门椎板成形术,作为对照组(B)组,两组患者术前术后进行JOA评分,计算神经功能改善率,并评估两组术后颈椎轴性症状严重程度,了解是否存在差异。结果两组患者术后神经功能改善恢复率,A组为(58.0士20.4)%,B组为(56.7士19.2)%,两组间差异无统计学意义。A组术后有明显轴性症状患者的比例为14.3%,B组为48.0%,两组比较差异有统计学意义(P<0.05)。结论保留颈半棘肌肌止,颈3椎板切除,颈4～"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脊髓减压效果,同时还减少了患者术后轴性症状的发生。[Objective] To verify whether the modified open-door laminoplasty is effective in preventing postoperative axial symptom and in decompression of spinal cord in treatment for cervical spondylotic myelopa- thy （CSM）, development spinal stenonsis and ossification of posterior longitudinal ligament （OPLL）. [Methods] Since September 2008 to December 2010, 28 patients who underwent extensive open-door laminoplasty, as reserved insertion of musculus semispinalis eervicis with C_3 laminectomy and C4-7 modified open-door laminoplasty using anchoring （Group A）, 25 patients who underwent conventional C3-7 open-door laminoplasty in the authors department were served as control （Group B）. Preoperative and postoperative improvement rate of Japanese Orthopedic Association （JOA） scores,axialsyndrome were recorded and compared. [Results] The average of JOA improvement rate was （58.0＋20.4） % for group A, and （56.7±19.2） % for group B. The rate of patients with evident axial symptom was 14.3% in group A and 48.0% in group B. [Conclusions] Modified open-door laminoplasty is effective in preventing postoperative axial symptom with adequate decompression of the spinal cord.

关 键 词：颈半棘肌 脊髓型颈椎病 轴性症状 椎管扩大成形术 

分 类 号：R681.55[医药卫生—骨科学]