悬吊固定与微型钛板固定在颈椎单开门椎管扩大椎板成形术中的应用效果比较  

Comparison of effects of suspension fixation and miniature titanium plate fixation in treatment of patients with cervical posterior longitudinal ligament ossification after cervical single door laminoplasty

作　　者：刘懿锋 LIU Yifeng(The Third Department of Orthopedics of Chaoyang Central Hospital,Chaoyang 122000 Liaoning,China)

机构地区：[1]朝阳市中心医院骨三科,辽宁朝阳122000

出　　处：《中国民康医学》2022年第9期139-142,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较悬吊固定与微型钛板固定在颈椎单开门椎管扩大椎板成形术中的应用效果。方法:选取230例行颈椎单开门椎管扩大椎板成形术治疗的颈椎后纵韧带骨化症(OPLL)患者为研究对象,按随机数字表法分为悬吊组101例与钛板组129例。悬吊组进行悬吊固定,钛板组进行微型钛板固定,比较两组手术相关指标(术中失血量、手术时间、术后引流量和医疗费用)水平、颈椎活动度(ROM)、日本骨科学会(JOA)评分、血清骨保护素(OPG)水平、核因子-kB受体活化因子配体(RANKL)水平和并发症发生率。结果:悬吊组医疗费用低于钛板组,差异有统计学意义(P<0.05);术后6个月,两组ROM均低于术前,但悬吊组高于钛板组,差异有统计学意义(P<0.05);两组术中失血量、手术时间、术后引流量、术后6个月JOA评分、出院时OPG水平、出院时RANKL水平和并发症发生率比较,差异均无统计学意义(P>0.05)。结论:悬吊固定应用于颈椎单开门椎管扩大椎板成形术治疗OPLL患者可提高ROM,降低医疗费用,效果优于微型钛板固定。Objective:To compare effects of suspension fixation and miniature titanium plate fixation in treatment of patients with cervical posterior longitudinal ligament ossification(OPLL)after cervical single door laminoplasty.Methods:230 patients with OPLL who underwent cervical single door laminoplasty were selected as the research subjects.According to the random number table method,they were divided into suspension group(101 cases)and titanium plate group(129 cases).The suspension group was given the suspension fixation,while the titanium plate group wan fixed with the miniature titanium plate.The levels of surgery-related indicators(intraoperative blood loss,operation time,postoperative drainage and medical expenses),the cervical range of motion(ROM),the Japanese orthopaedic association(JOA)score,the serum osteoprotegerin(OPG)level,the receptor activator of NF-kB ligand(RANKL)level and the incidence of complications were compared between the two groups.Results:The medical expenses of the suspension group were lower than that of the titanium plate group,and the difference was statistically significant(P<0.05).6 months after the surgery,the ROM levels of both groups were lower than that before the surgery however,that of the suspension group was higher than that of the titanium plate group;and the differences were statistically significant(P<0.05).However,there were no significant differences in intraoperative blood loss,operation time,postoperative drainage,JOA score 6 months after the surgery,OPG level at discharge,RANKL level at discharge and the incidence of complications between the two groups(P>0.05).Conclusions:Suspension fixation for the patients with OPLL after cervical single door laminoplasty can improve the ROM and reduce the medical expenses.Moreover,it is superior to miniature titanium plate fixation.

关 键 词：颈椎后纵韧带骨化症 颈椎单开门椎管扩大椎板成形术 悬吊固定 微型钛板固定 颈椎活动度 

分 类 号：R681.5[医药卫生—骨科学]