两种颈后路减压手术后轴性疼痛发生情况的比较  

A comparison of axial spine pain between patients who underwent two different posterior cervical decompression approaches

作　　者：刘晓伟[1] 许斌[1] 廖心远[2] 杨海松[2] 赵建宁[1] 陈德玉[2] 

机构地区：[1]南京军区南京总医院骨科,南京210002 [2]上海长征医院脊柱外科,200003

出　　处：《中国矫形外科杂志》2015年第3期202-205,共4页Orthopedic Journal of China

摘　　要：[目的]比较颈后路单开门椎管扩大成形术(One-door open Laminoplasty,Lam组)和颈后路椎板切除减压内固定术(lamninectomy with implant fixation,LIF组)术后轴性疼痛发生情况。[方法]回顾性纳入接受Lam(n=74)和LIF术式(n=51)的病例,比较两组病例轴性疼痛发生情况、神经功能改善率(improvement rate of neurological function,IR)及颈部功能障碍指数(neck dysfunction index,NDI)改善率的差异,分析轴性疼痛对神经功能、颈部功能障碍的影响。[结果]Lam组病例的轴性疼痛发生率、疼痛视觉模拟评分(visual analogue scale,VAS)和疼痛完全缓解所需时间均明显低于LIF组病例(P<0.05)。两组病例术前神经功能和NDI均无明显差别(P>0.05),分别随访29.4个月和33.1个月后(P>0.05),两组病例IR无明显差别(P>0.05),LIF组NDI改善率显著低于Lam组(P<0.05)。相关性分析提示轴性疼痛的发生与否和IR、NDI改善率均无明显相关性(P>0.05)。[结论]接受Lam术式的病例轴性疼痛发生率、疼痛评分和完全缓解所需时间均明显低于接受LIF术式的病例,且颈部功能障碍恢复情况优于后者。[Objective] To compare postoperative axial spine pain in patients who underwent one- door- open laminoplasty（ group LAM） and laminectomy with implant fixation（ group LIF）. [Methods] We retrospectively reviewed 74 cases in group LAM and 51 in group LIF. The indexes of axial pain,improvement in neurological status,and effect of pain on the patients＇ postoperative neurological function（ IR） and neck dysfunction index（ NDI） were analyzed. [Results] The axial pain incidence,visual analogue scale（ VAS） score,and complete remission duration in group LAM were all significantly lower than those in group LIF（ P〈0. 05）. There were no significant differences in the IR and NDI between the groups（ P〈0. 05）. After29. 4 months and 33. 1 months of follow- up,there were significant differences in the NDI improvement rate between the groups（ P〈0. 05）,but there was no significant difference in the IR（ P〈0. 05）. We found no significant correlations between the occurrence of axial pain and IR or the NDI improvement rate（ P〈0. 05）. [Conclusion] The axial pain incidence,VAS scores,and complete remission duration of axial pain in patients who underwent laminoplasty are significantly lower than those who underwent laminectomy,and the improvement of neck dysfunction in group LAM is better than that in group LIF.

关 键 词：颈后路单开门椎管扩大成形术 颈后路椎板切除减压内固定术 轴性疼痛 

分 类 号：R687.3[医药卫生—骨科学]