保留伸颈结构的颈后路有限化双开门治疗颈椎管狭窄症  

Finity double door laminoplasty with preservation of flection structure in the treatment of cervical canal stenosis

作　　者：卢中道[1] 翟明玉[1] 杨勇[1] 梅伟[1] 

机构地区：[1]郑州市骨科医院,450052

出　　处：《中国实用医刊》2013年第20期66-68,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察对传统颈后路双开门椎管扩大成形术进行改良，保留伸颈结构的有限化双开门的手术疗效。方法治疗颈椎管狭窄症61例，观察组30例给予颈后路有限化双开门椎管扩大成形术，术后随访12—27个月，平均18个月；对照组31例行传统第3～7颈椎双开门椎管扩大成形术，随访12—31个月，平均19．6个月。比较两组患者手术时间、出血量，手术前后的JOA评分及轴性症状严重程度。结果观察组JOA评分恢复率为64．6％，对照组为62．8％，两组比较差异无统计学意义（P〉0．05）。两组在手术时间、出血量、术后轴性症状发生率方面比较差异有统计学意义（P〈0．05）。结论保留伸颈结构的颈后路有限化双开门在获得良好脊髓减压效果的同时，可以减少手术时间，减少对颈椎后伸结构和颈椎稳定机制的破坏，最大程度维持颈背肌结构和功能的完整性，从而保留颈椎的活动度和降低术后颈椎轴性症状的发生。Objective To observe the effect of changed double door laminoplasty on cervical canal stenosis. Methods Sixty-one cervical canal stenosis patients were divided into two groups. The 30 patients in observation group were treated by finity double door laminoplasty, the average follow-up time were 18 months （range, 12-27 months）. The 31 cases in control group were treated by traditional double door laminoplasty from 3-7 cervical, the average follow - up time were 19.6 months （range, 12-31 months） . The operation time, the amount of bleeding, preoperative and postoperative Japanese Orthopedic Association （JOA） scores, cervical curvature angle, ranges of neck motion and the degree of axial symptom between the two groups were compared. Results The mean postoperative JOA score recovery rate of observe group and control group was 64. 6% and 62. 8% respectively. There was no significant difference between them （P 〉 0. 05 ）, there were significant differences between them in the operation time, the amount of bleeding, evident axial symptoms and loss of ranges of neck motion （P 〈 0. 05）. Conclusions Finity double door laminoplasty with preserva-tion of flection function is effective in neurological decompression. And it can maximumly maintain the struc-ture and function of the nuchal muscles. It is less invasive to the posterior extensor mechanism and the stabili-zation mechanism, it is effective in preventing postoperative axial symptoms with preservation of the ROM of the cervical spine in the treatment of cervical canal stenosis.

关 键 词：颈椎病 椎板切除术 椎板成形术 伸颈结构 

分 类 号：R687.3[医药卫生—骨科学]