枕颈融合联合扩大成形减压治疗枕颈区畸形  

Occipitocervical fusion combined expansive laminoplasty in the treatment of craniovertebral junction deformities

作　　者：黄凯[1] 唐旭东[1] 周永强[1] 陈安富[1] HUANG Kai;TANG Xu-dong;ZHOU Yong-qiang;CHEN An-fu(Dept of Orthopaedics, the First People′s Hospital of Neijiang City, Neijiang,Sichuan 641000, China)

机构地区：[1]内江市第一人民医院骨科,四川内江641000

出　　处：《临床骨科杂志》2019年第2期132-135,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨枕颈融合联合扩大成形减压术在治疗枕颈区畸形中的应用价值。方法对18例枕颈区畸形患者行后路颈椎管扩大成形、脊髓减压、枕颈融合、取髂骨植骨内固定术。采用JOA评分评价患者功能改善情况。结果患者均获得随访,时间13～38个月。15例术后3个月植骨融合,3例术后6个月植骨融合。无脑脊液漏、脊髓损伤加重、脊髓空洞等并发症。术后12个月JOA评分为13～18(15. 42±0. 52)分,较术前8～12(11. 52±0. 79)分明显改善(P <0. 05),改善率为71%。结论枕颈融合联合椎管扩大成形术能有效解除枕颈段脊髓压迫、稳定上颈椎,是脊髓减压、重建上颈椎稳定性有效、可靠的方法。Objective To investigate the clinical efficacy of occipitocervical fusion combined expansive laminoplasty for craniovertebral junction deformities. Methods The 18 patients with craniovertebral junction deformities were performed occipitocervical fusion combined expansive laminoplasty.JOA score was used to evaluate the patient′s function and improvement condition. Results All patients were followed up for 13~38 months.The 15 cases had bone graft fusion at 3 months after operation,3 cases had bone graft fusion at 6 months postoperatively. There were no complications such as cerebrospinal fluid leakage, aggravation of spinal cord injury and spinal cavity.The JOA score at 12 months after operation was 13~18 (15.42±0.52),which was higher than that of 8~12(11.52±0.79) before operation ( P <0.05), and the improvement rate was 71%. Conclusions Occipitocervical fusion combined expansive laminoplasty which effectively decompress cervical spinal cord and offer strong fixation, is an effective and reliable method for decompressing spinal cord and cervical stability.

关 键 词：枕颈融合 椎管扩大成形 枕颈区畸形 

分 类 号：R687.3[医药卫生—骨科学] R681.5[医药卫生—外科学]