颈椎单开门椎管扩大成形术不同椎板固定方法治疗多节段脊髓型颈椎病的临床研究  

An investigation of clinical effects of different fixing approaches of vertebral plate in cervical vertebra open-door expansive laminoplasty in the treatment of multi-segmental cervical spondylotic myelopathy

作　　者：黄春辉[1] 吴益奇[1] 卢海川[1] 

机构地区：[1]福建医科大学附属龙岩第一医院,福建龙岩364000

出　　处：《中国现代医生》2015年第8期12-14,18,共4页China Modern Doctor

摘　　要：目的分析颈椎单开门椎管扩大成形术（CL）两种不同椎板固定方法治疗多节段脊髓型颈椎病（CSM）的临床效果。方法选择2009年7月~2013年7月在我院接受手术多节段CSM患者80例,分为采用微型钛板固定的观察组和采用传统的丝线悬吊方法固定的对照组,每组各40例。比较两组患者手术时间、术中出血量、术后1周的JOA评分等。结果两组的手术时间、术中出血量差异不显著（P均〉0.05）;观察组术后1周的JOA评分[（10.32±2.18）]高于对照组[（9.01±1.09）],观察组患者改善率≥25%有36例,高于对照组的28例;观察组并发症发生率为7.50%,明显低于对照组的25.00%（P〈0.05）。结论 CL术结合微型钛板内固定方法治疗多节段CSM术后疗效良好,且并发症少,值得推广。Objective To analyze the clinical effects of two fixing approaches of vertebral plate in cervical vertebra open-door expansive laminoplasty in the treatment of multi-segmental cervical spondylotic myelopathy（CSM）. Methods Eighty patients with multi-segmental CSM who received surgery in our hospital from July 2009 and July 2013 were selected. They were allocated to an observation group who received fixation of miniature titanium plates and a control group who received conventional approach of silk hanging, 40 patients in each group. Surgical time, volume of bleeding during surgery, and JOA scores 1 week after the surgery in the two groups were collected. Results Surgical time and volume of bleeding in the two groups were not statistically significant（ all P 〉 0. 05）; JOA scores 1 week after the surgery [（10.32±2.18）] in the observation group was higher than that [（9.01±1.09）] in the control group. Improvement rate of 36 patients in the observation group was ≥25%, and the number of patients was more than that of 28 patients in the control group; incidence of complications in the observation group was 7.50%, significantly lower than that of 25.00% in the control group（P〈0.05）. Conclusion Expansive laminoplasty combined with fixation of miniature titanium plates in the treatment of multi-segmental CSM has a favorable postoperative effect and rare complications, which is worthy of clinical promotion.

关 键 词：椎管扩大成形术 脊髓型颈椎病 微型钛板固定 

分 类 号：R687.3[医药卫生—骨科学]