颈椎后路单开门椎管扩大成形联合微型钛板固定术治疗多节段脊髓型颈椎病  

Treatment of Multilevel Cervical Spondylto ic Myelopathy by Cervical Posterior Unilateral Expansive Open-door Laminoplasty and Using Mini Titanium Plate Fixation

作　　者：谭健[1] 李平元[1] 欧军[1] 苏小桃[1] 卢政好[1] 

机构地区：[1]南华大学附属南华医院脊柱外科,湖南衡阳421002

出　　处：《中国伤残医学》2014年第15期2-4,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨单开门椎管扩大成形联合微型钛板固定术治疗多节段脊髓型颈椎病疗多节段脊髓型颈椎病的临床效果。方法：回顾性分析本院2009年7月～2012年12月21例多节段脊髓型颈椎病患者，均采用颈椎后路单开门椎管扩大成形联合微型钛板固定术治疗；年龄47～68岁，平均年龄55．3岁；术前及术后末次随访时对患者脊髓功能进行日本整形外科学会（ Jap-anese Orthopaedic Association ，JOA）评分，以JOA评分改善率评价术后神经功能改善情况；术后对轴性疼痛采用VAS评分；末次随访时行X线片和MRI检查评价内固定位置及脊髓受压改善情况。结果：21例患者手术后随访12～24个月，平均15．8个月。术后神经功能明显改善，JOA评分由术前的8．3±2．2分提高到末次随访的14．3±1．7分（P＜0．01），平均改善率为69．0％；颈部轴性疼痛2例，发生率为9．52％，末次随访时VAS评分平均为2．13±0．33；末次随访时行X线片和MRI检查示微型钛板位置良好，未见松动及断裂，无再关门现象发生。结论：单开门椎管扩大成形联合微型钛板固定术治疗多节段脊髓型颈椎病效果满意，具有操作简便、固定牢靠、并发症少的优点。Objective：To investigate the clinical effect of cervical posterior unilateral expansive open -door laminoplasty with mini tita-nium plate fixation in the treatment of multilevel cervical spondylotic myelopathy .Methods：A retrospective analysis of our hospital from July 2009 to December 2012 21 cases of multilevel cervical spondylotic myelopathy patients , underwent cervical posterior unilateral expan-sive open-door laminoplasty with mini titanium plate fixation;age 47 to 68 years old, average 55.3 years old;preoperative and postoper-ative at last follow-up for patients with spinal cord function of Japanese Orthopaedic Association （ JOA） score, improvement rate of JOA score evaluation of postoperative neurological function improvement;VAS score of postoperative axial pain;at the last follow-up X-ray and MRI examination evaluation internal fixation position and spinal cord compression to improve the situation .Results：21 patients were followed up for 12~24 months after surgery , average 15.8 months.Nerve function were improved after surgery , JOA score from preopera-tive 8.3 ±2.2 to the last follow-up of 14.3 ±1.7 （P〈0.01）, the average improvement rate was 69%;2 cases of neck axis pain , the incidence rate was 9.52%, the average VAS score was 2.13 ±0.33 at last follow-up;at the last follow-up X-ray and MRI examina-tion showed mini titanium plate in good position , no loosening and fracture , had no door closed phenomenon .Conclusion：Cervical posteri-or unilateral expansive open -door laminoplasty with mini titanium plate fixation in the treatment of multilevel cervical spondylotic myelop -athy with satisfied effect , has the advantages of simple operation , reliable fixation , less complication .

关 键 词：脊髓型颈椎病 单开门椎管扩大成形 微型钛板 

分 类 号：R681.5[医药卫生—骨科学]