颈_3椎板颈_7上半椎板切除及颈_(4～6)椎管扩大成形术的临床初步应用  

Preliminary clinical application experience of C_3 laminectomy,upper half of C_7 laminectomy and C_(4～6) laminoplasty

作　　者：庞伟 翁兴彦 刘玉秋 刘少敏 武树森 王首强 胡临[2] 张贵林[2] 

机构地区：[1]辽宁省辽阳市第二人民医院脊柱外科,111000 [2]北京积水潭医院脊柱外科

出　　处：《中国骨与关节损伤杂志》2013年第3期201-203,共3页Chinese Journal of Bone and Joint Injury

基　　金：辽宁省辽阳市科学研究立项支持项目(2012-21)

摘　　要：目的通过对多节段脊髓型颈椎病、颈椎后纵韧带骨化症、颈椎外伤患者行“C3椎板切除、C7上半椎板切除、C4-6椎管扩大成形术”治疗，探讨颈椎病的创新手术治疗方法。方法对84例多节段脊髓型颈椎病、颈椎后纵韧带骨化症、颈椎外伤患者进行颈椎正、侧位及动力位X线片、椎管造影、CT、CTM、MRI等检查，明确诊断，确定有手术指征后，行“C3椎板切除、C7上半椎板切除、C4-6椎管扩大成形术”治疗。结果本组83例获得3-24个月的随访，平均14．7个月，患者均有比较满意的功能恢复。术前平均JOA评分7.05分，术后平均9．1分，末次复查时平均JOA评分10．38分。植人人工骨位置理想，愈合满意。出现G神经根牵拉、轴性疼痛等并发症，经处理后逐渐恢复。结论“C3椎板切除、C7上半椎板切除、C4-6椎管扩大成形术”，手术方法简便，适于掌握，手术时间短、出血少，预后好，患者恢复快，是一种术式合理并方便推广应用的治疗方法。。Objective Based on the operation C3 laminectomy, upper half of C7 laminectomy and C4-6 laminoplasty for multilevel cervical spondylotic myelopathy, ossification of the cervical posterior longitudinal ligament and cervical spine trauma patients, to investigate a new operative method for cervical spondylotic myelopathy. Methods In 84 patients with multilevel cervical spondylotic myelopathy, ossification of the cervical posterior longitudinal ligament and cervical spine trau/na, lateral and dynamic X radiographs, myelography, CT, CTM, MRI examination were used to get a definitive diagnosis. Under general anesthesia, C3 laminectomy, upper half of C7 laminectomy and C~ laminoplasty were performed. Results Eighty three patients received 3~24 months of follow-up, with an average of 14.7 months. All patients got satisfactory functional recovery. The mean preoperative JOA score was 7.05 points, after operation, averaging 9.1 points, 10.38 points at last follow-up. Artificial bone implantation had ideal location and healing. C5 nerve root traction, axial pain and other complications occurred sometimes, but dissapeared after treatment. Conclusion C3 laminectomy, upper half of C7 laminectomy and C4-6 laminoplasty is simple to perform, with short operation time, less bleeding, good prognosis, fast recovery. It＇s a reasonable surgical method with convenient popularization.

关 键 词：颈椎病 椎板切除 椎管扩大成形术 

分 类 号：R687[医药卫生—骨科学]