单开门术中锚定法与Arch钛板固定治疗脊髓型颈椎病的疗效比较  

Comparison of the effects of anchorage and Arch titanium plate fixation of cervical spinal canal enlargement in the treatment of cervical spondylotic myelopathy

作　　者：张仕锋 ZHANG Shi-feng(the Second People＇s Hospital of Pingdingshan,Pingdingshan,Henan,467000,China)

机构地区：[1]河南省平顶山市第二人民医院,河南平顶山467000

出　　处：《颈腰痛杂志》2018年第3期350-353,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的在脊髓型颈椎病(Cervical Spondylotic Myelopathy,CSM)行单开门颈椎管扩大成形术中,探讨"开门侧"采用锚定法与Arch钛板固定的治疗疗效差异。方法自2013-07-2015-09,采用后路单开门颈椎管扩大成形术治疗90例CSM患者,其中53例"开门侧"以锚定法处理(A组),37例"开门侧"予以Arch钛板固定处理(B组)。对两组术后手术时间、术中出血量、术前和术后JOA改善率、术后椎管扩大面积等指标进行对比。结果两种术式的手术时间、术中出血量无明显差异,且术后3个月的JOA评分改善率也较为相近(均为P>0.05);但B组术后24个月的JOA评分改善率显著优于A组,且其术后3个月时的椎管扩大率仅丢失(1.7±0.6)%,显著低于A组的(8.5±10.9)%,上述差异均有统计学意义(P<0.05)。A组9例出现轴性症状(24.3%),B组仅出现4例(7.5%),组间有显著性差异(P<0.05)。结论在后路单开门颈椎管扩大成形术中,予以Arch钛板固定后,患者后期颈椎功能改善情况更佳,能显著减少轴性症状发生率,更好地保持椎管开门效果。Objective To compare the effects of anchorage and Arch titanium plate fixation of cervical spinal canal enlargement in the treatment of cervical spondylotic myelopathy（CSM）. Methods From July 2013 to September 2015, 90 patients with CSM were treated with posterior single-door open cervical canal enlargement. Fifty-three cases of ＂open side＂ were treated with anchorage（group A）,and 37 cases of ＂open side＂ were treated with Arch titanium plate（group B）. The curative effect of the two groups was compared. Results There were no significant differences in the time of operation and the amount of bleeding between two groups, and the improvement rate of the JOA score 3 months after operation was similar in two groups（all P〈0.05）. But the improvement rate of JOA score in group B 24 months after operation was significantly better than that in group A. At 3 months after operation, the spinal canal enlargement rate was（1.7±0.6）%, which was significantly lower than（8.5±10.9）% in group A, and the difference was statistically significant（P 〉0.05）. In group A, 9 cases had axial symptoms（24.3%）, and only 4 cases（7.5%） were found in group B, there was significant difference between the two groups（P〈0.05）. Conclusion In the posterior open-door cervical laminoplasty, for the open door side, Arch titanium plate fixation can improve the cervical function better, significantly reduce the incidence of axial symptoms, and better maintain the effect of spinal canal opening.

关 键 词：脊髓型颈椎病 单开门颈椎管扩大成形术 锚定法 Arch钛板 

分 类 号：R681.55[医药卫生—骨科学]