改良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的临床疗效评价  

Clinical evaluation of modified posterior cervical open-door laminoplasty in the treatment of multi-segment cervical spondylosis myelopathy

作　　者：张林[1] 张兵[1] 鲍亮[1] 康晋[1] ZHANG Lin;ZHANG Bing;BAO Liang(Department of Orthopaedics,the Second Affiliated Hospital of Xi＇an Medical College,Xi＇an,Shanxi710038,China)

机构地区：[1]西安医学院第二附属医院骨科,陕西西安710038

出　　处：《颈腰痛杂志》2018年第6期718-720,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨多节段脊髓型颈椎病采用改良颈椎后路单开门椎管扩大成形术治疗的临床效果。方法将74例多节段脊髓型颈椎病患者随机分为研究组(37例)和对照组(37例),研究组采用改良颈椎后路单开门椎管扩大成形术,对照组采用传统C3-7单开门椎板成形术治疗,观察对比相关指标。结果研究组手术时间、术中出血量明显低于对照组(P<0.05),研究组术后并发症发生率为10.81%,略低于对照组的24.32%(P>0.05);随访1年,两组术后JOA评分改善率无显著差异(P>0.05);研究组ROM丢失度明显小于对照组,CCI丢失率明显低于对照组(P<0.05)。结论采用改良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患者效果显著,可有效降低术后并发症发生率,改善ROM及CCI,值得推广应用。Objective To discuss the clinical effect of modified posterior cervical open -doorlaminoplasty in the treatment of multi-segment cervical spondylosis myelopathy. Methods Seventy-four patients with multi-segment cervical spondylosis myelopathy treated in our hospital were randomlydivided into study group （37 cases） and control group （ 37 cases）. The study group was treated withmodified posterior cervical open-door laminoplasty, while the control group was treated with traditionalopen door laminoplasty of C3 -7 for treatment. The operation time, bleeding volume, incidence rate ofpostoperative complication, improvement rates of JOA scores, cervical range of motion （ROM） andcervical curvature indicators （CCI） were compared between the two groups. Results The operationtime and bleeding volume in the study group were obviously lower than those in the control group （P〈0.05）, and the incidence rate of complications in the study group was 10.81%, which was slightly lowerthan 24.32% in the control group （P〉0.05）. The patients were followed up for 1 year, there was noobvious difference in the improvement rate of JOA scores （P〉0.05）.The ROM loss degree in the studygroup was obviously less than that in the control group, and the CCI loss rate was obviously lower thanthat in the control group （P〈0.05）. Conclusion The effect of modified posterior cervical open-doorlaminoplasty in the treatment of multi-segment cervical spondylosis myelopathy is significant, whichcan effectively reduce the incidence rate of complications after operation and improve the ROM andCCI, it is worthy of wide promotion and application in clinic.

关 键 词：改良 颈椎后路 单开门椎管扩大成形术 脊髓型颈椎病 

分 类 号：R687.3[医药卫生—骨科学]