单开门椎板成型术治疗老年脊髓型颈椎病  

Surgical results of open-door laminoplasty in elderly patients with cervical myelopathy

作　　者：孙元亮[1] 刘艳娣[2] 李牧[1] 祁磊[1] 

机构地区：[1]青岛大学附属医院,山东青岛226000 [2]青岛农业大学

出　　处：《中国矫形外科杂志》2016年第7期589-593,共5页Orthopedic Journal of China

摘　　要：[目的]探讨老年脊髓型颈椎病的主要病理机制并对单开门椎板成型术在治疗老年脊髓型颈椎病中疗效予以评价。[方法]2000年3月~2008年3月,40例年龄在70岁以上的老年脊髓型颈椎病患者,平均75.4岁（70~85岁）于本科行单开门椎板成型术。在此同一时期内选择40例年龄在60岁以下脊髓型颈椎病患者作为对照组,平均51.2岁（33~60岁）。所有患者至少随访3年,平均6.7年（3~10年）。分别对手术前后JOA评分、改善率、影像学表现及术后并发症进行统计分析。[结果]两组患者术后JOA评分均有显著改善,老年组术后2年效果最佳,术后5年改善率略低与对照组,但无统计学差异。老年组术前颈椎动力位X线片示颈椎不稳发生率明显高于对照组。[结论]单开门椎板成形术可以达到解除神经压迫,维持颈椎稳定性的目的,并在治疗老年脊髓型颈椎病中有良好的疗效。[Objective] To evaluate the results of open-door laminoplasty in elderly patients. [Methods] Forty patients（ age 70,range 70 ~ 85） who underwent original open-door laminoplasty were reviewed in this study. Another 40 patients（ age 60,range 33 ~ 60） were reviewed as the control group. All the patients were followed up for minimum 3 years,averaging 6. 7 years（ range 3 ~ 10 years）. Clinical results were compared between the two groups,including Japanese Orthopedic Association scores, recovery rates, postoperative compliacations. Radiologic features were also examined, so as to find out whether this surgical method was effective for elderly patients. [Results] Instability of the cervical spine was significantly higher in the elderly patient group than that of the control group in the preoperative radiographs. After surgery,the average JOA scores and recovery rates improved significantly and maintained an acceptable level in both groups. The improvement effect in the elderly patient group reached the top at 2 year postoperatively,and decreased at 5 year postoperatively,but without significant difference compared to that of control group. [Conclusion] The results of open-door laminoplasty are satisfactory in elderly patients.

关 键 词：颈椎病 椎板成形术 活动度 

分 类 号：R687.3[医药卫生—骨科学]