经椎板间隙减压术治疗黄韧带源性颈椎病  

Posterior decompression between vertebral laminae for multiple-level cervical spondylotic myelopathy

作　　者：吴继彬[1] 孙玛骥 张星晨[1] 吴东迎[1] 辛兵[1] 冯虎[1] 袁峰[1] 

机构地区：[1]徐州医学院附属医院骨科,江苏徐州221006

出　　处：《中国矫形外科杂志》2016年第23期2125-2128,共4页Orthopedic Journal of China

摘　　要：[目的]探讨经椎板间隙减压术在治疗黄韧带增生所致脊髓型颈椎病的临床应用及其随访结果。[方法]自2012年3月~2015年3月在本院行颈椎后路经椎板间隙减压术并获得完整随访病例的黄韧带源性脊髓型颈椎病患者20例,男12例,女8例;年龄31~76岁,平均41.7岁。记录疼痛视觉模拟量表评分（visual analogue scale,VAS）、日本骨科学会评分（Japanese Orthopaedic Association,JOA）,Oswestry功能障碍指数评分（Oswestry disability index,ODI）和颈椎生理曲度D值并进行统计学分析,比较术后与术前的差异。[结果]所有患者均未出现术中神经血管损伤等并发症。平均手术时间（100±12.5）min,术中出血量约（200±30.5）ml,术后引流量约（90±18.4）ml。随访时间为术后2周、1个月和3个月。术后2周VAS评分、ODI评分和JOA评分与术前比较差异有统计学意义（P〈0.05）,并且维持到术后1个月和3个月。术后2周颈椎生理曲度D值与术前比较差异有统计学意义（P〈0.05）,并且维持到术后1个月和3个月。[结论]经椎板间隙减压术治疗黄韧带源性脊髓型颈椎病减压效果明显。出血量、手术时间、损伤脊髓神经的风险均达到最小化,术后患者恢复好。[ Objective ] To investigate the clinical results of posterior decompression between vertebral laminae for multiple - level cervical spondylotic myelopathy. [ Methods ] A retrospective review was performed on 20 patients with multiple - level cervical spondylotic myelopathy undergoing posterior decompression between vertebral laminae from March 2012 to March 2015. Clinical efficacy was evaluated by VAS score, JOA score, ODI score and cervical curvature value D. [Results] All pa- tients appear no intraoperative complications such as nerve, blood vessel damage. The average operation time was （ 100±12. 5 ） min, the average blood loss during operation was （200± 30. 5 ） ml, the average postoperative drainage was （90 ± 18.4） ml. In addition, significant improvements were found in postoperative scores of VAS, ODI, JOA and D value compared with the preoperative data （P 〈 0.05 ） . The satisfactory clinical outcomes continued to 3 months postoperatively. [ Conclusion ] Posterior decompression between vertebral laminae for the treatment of multiple - level cervical spondylotic myelopathy is an effective method, which has not only some traditional advantages, such as smaller trauma, 1 ess bleeding, postoperative drainage and short operation time, but also more satisfactory function recovery.

关 键 词：脊髓型颈椎病 经椎板间隙减压术 颈椎后路 

分 类 号：R687.3[医药卫生—骨科学]