颈后路单开门椎管成形术术式改良的研究进展  

Research progress of muscle ligament complex and muscle attachment point preservation or reconstruction in open door laminoplasty

作　　者：刘法敬(综述) 许海委[1] 田金辉 王雪(审校)[1] LIU Fajing;XU Haiwei;TIAN Jinhui;WANG Xue(Department of Spine Surgery,Tianjin Hospital,Tianjin 300000,China;Department of Spine Surgery,Handan central Hospital,Handan,Hebei 056001,China)

机构地区：[1]天津市天津医院脊柱外科,300000 [2]河北省邯郸市中心医院脊柱外科,056001

出　　处：《重庆医学》2022年第3期520-524,共5页Chongqing medicine

基　　金：国家自然科学基金青年科学基金项目(31500781);河北省医学科学研究重点课题计划项目(20191830)。

摘　　要：脊髓型颈椎病(CSM)是临床常见的一种脊柱退行性疾病,可导致四肢麻木、无力,甚至大小便功能障碍。单开门椎管成形术是治疗CSM的经典术式,但术中颈后肌群的大范围剥离及韧带复合体的破坏,使得术后颈部肌肉萎缩、颈椎曲度丢失及轴性疼痛症状在患者的恢复过程中如影随形。因此,临床上针对单开门椎管成形术的术式改良从未中断过,如保留或重建颈半棘肌的C2棘突止点、重建韧带复合体、在通道下椎管成形减少肌群损伤及设计新型内固定装置来重建颈后伸肌附着点等,以期获得一定程度的临床改善。本文就近年来关于肌肉附着点和韧带复合体保留及重建技术进行综述。Cervical spondylotic myelopathy(CSM)is a clinically common spinal degenerative disease,can lead to numbness and weakness of the limbs and even defecation and urination dysfunction.Open door laminoplasty is a classic procedure in treating CSM,but it can cause extensive posterior cervical muscle stripping and ligament complex destruction in the surgery,which makes the postoperative cervical muscle atrophy,cervical curvature loss and axial pain during the recovery process.Therefore,the surgical improvement of open door laminoplasty has never been interrupted.Such as retaining or reconstructing the semispinalis muscle in the C2 spinous process,reconstructing the ligament complex,laminoplasty under mobile micro endoscopic and designing a new fixation device to reconstruct the attachment point,etc.This paper review the preservation and reconstruction of muscle ligament complex and muscle attachment point at present.

关 键 词：脊髓型颈椎病 单开门椎管成形术 肌肉韧带复合体 轴性症状 

分 类 号：R681.5[医药卫生—骨科学]