椎板开门角度对多节段脊髓型颈椎病患者颈椎单开门微型钛板固定成形术的影响  

Effect of Lamina Door Opening Angle on Single-door Cervical Micro Titanium Plate Fixation in Patients with Multilevel Cervical Myelopathy

作　　者：王传菊 WANG Chuanju(Qianjiang Central Hospital,Qianjiang 433100,China)

机构地区：[1]潜江市中心医院,湖北潜江433100

出　　处：《中外医学研究》2022年第8期60-63,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨椎板开门角度对多节段脊髓型颈椎病(multilevel cervical myelopathy,MCM)患者颈椎单开门微型钛板固定成形术的影响。方法:回顾性选取潜江市中心医院2018年8月-2020年10月收诊的111例MCM患者,均行颈椎单开门微型钛板固定成形术。按照术后3个月复查椎板开门角度的不同分为试验组(55例,≤36.5°)与对照组(56例,>36.5°)。观察两组的住院时间、手术出血量及手术时间,评测其颈椎活动度、颈椎前凸指数、日本骨科协会评估治疗(Japanese Orthopaedic Association scores,JOA评分),统计其C_(5)神经根麻痹发生率,并比较两组的轴性症状发生率。结果:(1)试验组的住院时间(10.23±2.41)d、手术出血量(156.18±25.74)ml、手术时间(108.58±17.59)min,与对照组的(9.84±2.15)d、(158.70±26.97)ml、(110.28±19.53)min相比,差异无统计学意义(P>0.05)。(2)试验组术后3个月的颈椎活动度(31.47±2.48)°、颈椎前凸指数(9.82±1.56)、JOA评分(14.17±2.28)分,与对照组的颈椎活动度(31.04±2.32)°、颈椎前凸指数(10.34±1.68)、JOA评分(13.93±2.15)分相比,差异无统计学意义(P>0.05)。(3)试验组的C_(5)神经根麻痹发生率为1.82%,低于对照组的12.50%(P<0.05)。(4)试验组的轴性症状发生率为5.45%,低于对照组的21.43%(P<0.05)。结论:椎板开门角度≤36.5°有助于降低MCM患者C_(5)神经根麻痹与轴性症状的发生率,但在手术出血量、住院时间、颈椎活动度、脊髓神经功能等方面的改善效果与椎板开门角度>36.5°无明显差异。Objective:To investigate the influence of lamina door opening angle on cervical single-door micro titanium plate fixation in patients with multilevel cervical myelopathy(MCM).Method:A total of 111 patients with MCM admitted to Qianjiang Central Hospital from August 2018 to October 2020 were retrospectively selected,and all of them underwent cervical single-door micro titanium plate fixation.According to the different opening angles of the lamina after 3 months of reexamination,they were divided into two groups:the experimental group(55 cases,≤36.5°)and the control group(56 cases,>36.5°).The hospitalization time,surgical blood loss and operation time of the two groups were observed,the cervical spine mobility,cervical lordosis index,and the Japanese Orthopaedic Association scores(JOA score),the incidence of C_(5)nerve root palsy were evaluated,and the incidence of axial symptoms of the two groups were compared.Result:(1)The hospitalization time of the experimental group was(10.23±2.41)days,the surgical blood loss was(156.18±25.74)ml,and the operation time was(108.58±17.59)min,compared with the control group’s(9.84±2.15)days,(158.70±26.97)ml and(110.28±19.53)min,the differences were not statistically significant(P>0.05).(2)Three months after surgery cervical spine range of motion(31.47±2.48)°,cervical lordosis index(9.82±1.56),JOA score(14.17±2.28)points in the experimental group,compared with the control group’s cervical spine range(31.04±2.32)°,cervical lordosis index(10.34±1.68),JOA score(13.93±2.15)points,the differences were not statistically significant(P>0.05).(3)The incidence of C_(5)nerve root palsy in the experimental group was 1.82%,which was lower than 12.50% in the control group(P<0.05).(4)The incidence of axial symptoms in the experimental group was 5.45%,which was lower than 21.43%in the control group(P<0.05).Conclusion:The opening angle of the lamina≤36.5°is helpful to reduce the incidence of C_(5)nerve root palsy and axial symptoms in MCM patients,but its improvement effect

关 键 词：多节段脊髓型颈椎病 椎板开门角度 颈椎单开门微型钛板固定成形术 颈椎活动度 JOA评分 

分 类 号：R687.3[医药卫生—骨科学]