颈椎后路单开门椎板成形微型钛板内固定术治疗多节段颈椎管狭窄症  

Internal Fixation of Titanium Mini-plate in Posterior Cervical Single Open-door Laminoplasty for Multiple-segment Cervical Stenosis

作　　者：孙继飞[1] 陈庆胜[1] 郑铁刚[1] 何强[1] 刘振利[1] 

机构地区：[1]解放军251医院骨科,河北张家口075000

出　　处：《中国现代手术学杂志》2015年第5期358-361,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的总结颈椎后路单开门椎板成形微型钛板内固定术治疗多节段颈椎管狭窄症的临床效果。方法我科于2013年3月-2014年9月间应用颈椎后路单开门椎板成形微型钛板内固定术治疗多节段颈椎管狭窄症患者12例,其中发育性颈椎管狭窄合并颈椎间盘退行性变突出7例,发育性颈椎管狭窄合并后纵韧带钙化5例。手术前后均进行神经功能JOA评分,颈部轴性症状分级及行颈椎动态侧位片、颈椎MRI检查比较临床疗效。结果本组12例均获得随访,随访时间平均12（3-20）个月。术后脊髓功能JOA评分：优6例,良3例,可2例,差1例,优良率为75%。颈部轴性症状减轻,脊髓功能改善。随访时X线检查未见不稳,MRI示颈髓压迫得到解除。结论颈椎后路单开门椎板成形微型钛板内固定术治疗多节段颈椎管狭窄症疗效确切,对于有明确适应证患者是一种理想的手术方式。Objective To evaluate the clinical results on internal fixation of titanium mini-plate in posterior cervical single open-door laminoplasty for multiple-segment cervical stenosis. Methods A total of 12 patients with multiple-segment cervical stenosis were treated with internal fixation of titanium mini-plate in cervical single open-door laminoplasty from March 2013 to September 2014,including developmental cervical stenosis（ DCS） combined with cervical intervertebral disc degeneration in 7 cases and DCS combined with ossification of cervical posterior longitudinal ligament（ OPLL） in 5 cases. Neural function was assessed by JOA scoring system. The cervical axial symptoms,dynamic cervical spine lateral projection and cervical vertebra MRI were evaluated. Results All 12 cases were followed up for 3 to 20 months with an average of 12 months. The postoperative JOA score of spinal cord revealed excellence in 6 cases,good in 3 cases,fair in 2 cases and false in1 case,and the fineness rate was 75%. Cervical axial symptoms were improved and the spine cord function was restored. Instability of the cervical spine was not found and decompression was confirmed on MRI. Conclusion The internal fixation of titanium mini-plate in cervical single open-door laminoplasty is an ideal and effective procedure for multiple-segment cervical stenosis.

关 键 词：颈椎 椎管狭窄 椎板成形术 钛板 内固定器 

分 类 号：R687.3[医药卫生—骨科学]