颈后路单开门联合Centerpiece钢板内固定椎管扩大成形手术治疗多节段脊髓型颈椎病  

作　　者：林阳[1] 张宗[1] 潘剑成[1] 江海亮[1] 蒋华生 

机构地区：[1]中国人民解放军第181医院脊柱外科,广西桂林541002

出　　处：《湖南中医药大学学报》2016年第A01期338-339,共2页Journal of Hunan University of Chinese Medicine

摘　　要：目的通过回顾性分析运用Center piece钢板行颈椎后路单开门椎管扩大成形术治疗多节段脊髓型颈椎病,探讨其对于改善神经功能、颈椎曲度、颈椎活动度及轴性症状的临床效果.方法采用Centerpiece钢板行颈椎后路单开门椎管扩大形术治疗多节段脊髓型颈椎病22例,术前、术后常规行颈椎正侧位、动力位及 MRI检查,术前侧位片显示颈椎生理曲度均存在,记录术前、术后及各随访时间的颈椎生理曲度、JOA评分,疼痛视觉模拟评分（VAS）.结果所有患者在术后症状均得到了明显缓解,术前与术后在侧位 X 线片上测量C2 与C7椎体后壁切线夹角α确定颈椎曲度,以过伸过屈位α的差异来计算颈椎活动度,术前与术后无统计学意义（P〉0.05）;JOA评分、颈项疼痛 VAS评分比较均有统计学意义（P〈0. 05）.术后6-12个月患者均常规复查颈椎正侧位片,术后6月复查颈椎MRI,结果显示手术节段均未发生关门现象,稳定性良好,且椎管管径明显扩大,脊髓受压现象明显改善.结论应用Centerpiece钢板固定术施行颈椎管单开门扩大成形术可以有效维持开门状态的稳定,减少单开门术后并发症,有效降低了手术难度,保证了手术效果,是一项相对比较理想的治疗脊髓型颈椎病的手术方式.objectivethrough the retrospective analysis using the Centerpiece steel line cervical posterior single door segment myelopathic type was more construction of vertebral canal expanded for cervical spondylosis, explore its for improve nerve function, cervical curvature, and axial symptoms the clinical effect of cervical spine mobility. Methodadopting the Centerpiece steel line cervical posterior single door for the treatment of vertebral canal expanded form more segmental myelopathic type was 22 cases of cervical spondylosis, preoperative and postoperative routine positive side, power lines of cervical vertebrae and MRI, preoperative side showed cervical physiological curvature, record the preoperative and postoperative cervical physiological curvature and the follow-up time, JOA score, visual analogue scale （VAS） pain. Resultsall patients in the postoperative symptoms were obviously alleviate, preoperative and postoperative in lateral X ray film on the measurement of C2 and C7 vertebral wall tangent Angle after cervical curvature is determined, through a bend with passing an alpha differences to calculate the activity of cervical vertebra, preoperative and postoperative had no statistical significance （P 〉 0.05）; JOA score, neck pain VAS score comparison had statistical significance （P 〈 0. 05）. Patients with postoperative 6 and 12 months are routinely review cervical lateral slice, review in June after cervical spine MRI, results show that the operation section has not been closed occur, good stability, and a significant increase in the spinal canal diameter of spinal cord compression phenomenon obviously improved. Conclusionthe Centerpiece and plate fixation of cervical vertebra tube single door to expand plasty can effectively maintain the stability of open state, reduce the postoperative complications, single door effectively reduced the operation difficulty and ensure the operation effect, is a relatively ideal surgical procedure for the treatment of myelopathic type cervical vertebra di

关 键 词：多节段脊髓型颈椎病 颈椎后路 Centerpiece 

分 类 号：R2[医药卫生—中医学]