微型钛板固定法治疗多节段脊髓型颈椎病的临床效应  

The Clinical Effect of Mini-Titanium Plate Fixation on the Treatment of Multilevel Cervical Spondylotic Myelopathy

作　　者：李海涛[1] 孙丽静 Li Haitao;Sun Lijing(Handan Central Hospital,Handan,056001)

机构地区：[1]邯郸市中心医院

出　　处：《基因组学与应用生物学》2019年第7期3213-3218,共6页Genomics and Applied Biology

摘　　要：为了比较丝线悬吊和微型钛板两种椎板固定方法对颈椎单开门椎管扩大成形术治疗多节段脊髓型颈椎病的影响,2016年4月至2018年1月期间,本研究选择我院收治的64例多节段脊髓型颈椎病患者作为研究对象。将患者随机分为对照组(丝线悬吊)和观察组(微型钛板固定),每组32例。比较两组的围手术期指标和治疗1年后的神经功能(JOA评分)、疼痛程度(VAS评分)、颈椎轴性症状、颈椎曲度和并发症。研究显示,两组患者的手术时间、术中出血量和引流量均无统计学差异(p>0.05)。两组患者术后的JOA评分和神经功能改善率无显著差异(86.36%vs.81.41%)(p>0.05)。术后观察组的VAS评分显著低于对照组(p=0.036)。观察组患者的颈椎轴性症状发生率(16.33%)显著低于对照组(25.58%)(Z=-2.024,p=0.043)。治疗12个月后观察组和对照组患者的颈椎曲度分别丢失了1.30%和4.62%,观察组颈椎曲度丢失量显著低于对照组(p=0.032)。本研究说明,在应用颈椎单开门椎管扩大成形术治疗多节段脊髓型颈椎病中,与丝线悬吊椎板固定相比,微型钛板固定可明显减少疼痛程度、颈椎曲度丢失和轴性症状的出现。To compare the effects of silk suspension and mini-titanium plate lamina fixation on the treatment of multilevel cervical spondylotic myelopathy with single-door laminoplasty of cervical spine,from April 2016 to January 2018,64 patients with multilevel cervical spondylotic myelopathy admitted to our hospital were selected as the study subjects.The patients were randomly divided into control group(silk suspension)and observation group(mini-titanium plate fixation),32 cases in each group.The perioperative indexes,neurological function(JOA score),pain degree(VAS score),cervical axis symptoms,cervical curvature and complications after 1 year of treatment were compared between the two groups.The study showed that there was no significant difference in operation time,intraoperative bleeding volume and drainage volume between the two groups(p>0.05).There was no significant difference in JOA score and neurological improvement rate between the two groups(86.36%vs.81.41%)(p>0.05).The VAS score of the observation group was significantly lower than that of the control group(p=0.036).The incidence of cervical axial symptoms in the observation group(16.33%)was significantly lower than that in the control group(25.58%)(Z=-2.024,p=0.043).After 12 months of treatment,the cervical curvature of the observation group and the control group lost 1.30%and 4.62%,respectively.The cervical curvature of the observation group was significantly lower than that of the control group(p=0.032).In the treatment of multilevel cervical spondylotic myelopathy with single-door laminoplasty of cervical spine,mini-titanium plate fixation can significantly reduce pain,cervical curvature loss and axial symptoms compared with silk suspension lamina fixation.

关 键 词：微型钛板固定 颈椎单开门椎管扩大成形术 多节段脊髓型颈椎病 椎板固定 颈椎曲度 轴性症状 

分 类 号：R687.3[医药卫生—骨科学]