颈后路单开门椎管扩大成形术和全椎板切除减压术治疗脊髓型颈椎病的中短期疗效分析  

Analysis of short to medium-termefficacy of posterior cervical expansive open-door laminoplasty and posterior cervical laminectomy and fusion in treating cervical spondylotic myelopathy

作　　者：马旭东 高海 孔雷[2] 张文志[2] 黄炎 MA Xu-dong;GAO Hai;KONG Lei;ZHANG Wen-zhi;HUANG Yan(Graduate School of Bengbu Medical College,Bengbu,Anhui 233030,China;Department of Spinal Surgery,Anhui Provincial Hospital,Hefei,Anhui 230001,China)

机构地区：[1]蚌埠医学院研究生院,安徽蚌埠233030 [2]安徽省立医院脊柱外科,安徽合肥230001

出　　处：《颈腰痛杂志》2022年第6期835-837,841,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的 比较颈后路单开门椎管扩大成形术(posterior cervical expansive open-door laminoplasty, EODL)与颈后路全椎板切除减压术(posterior cervical laminectomy and fusion, PCLD)治疗多节段脊髓型颈椎病的临床效果。方法 回顾性分析2017年1月~2020年12月在本院行颈椎后路手术的56例患者,其中行EODL手术(EODL组)和PCLD手术(PCLD组)各28例。对两组患者术前、术后3个月以及末次随访时的改良JOA评分、VAS评分和手术前后的颈椎CCobb角变化进行分析。结果 所有患者均获随访。与术前相比,两组术后3个月及末次随访改良JOA评分和VAS评分均显著改善(P<0.05);两组间差异无统计学意义(P>0.05)。与术前相比,两组患者末次随访的CCobb角均显著降低(P<0.05)。两组患者住院时间、手术时间差异均无统计学意义(P>0.05),PCLD组的术中出血量显著高于EODL组(P<0.05)。结论 两种手术方式均对多节段脊髓型颈椎病的神经功能有改善作用,但均降低了颈椎的前凸曲度。Objective To compare the clinical effects of posterior cervical expansive open-door laminoplasty(EODL) and posterior cervical laminectomy and decompression(PCLD) in the treatment of multilevel cervical spondylotic myelopathy. Methods Retrospective analysis was conducted in 56 patients who underwent posterior cervical surgery in our hospital from January 2017 to December 2020, including 28 patients who underwent EODL surgery(EODL group) and 28 patients who underwent PCLD surgery(PCLD group). The modified JOA score, VAS score and the changes of CCobb angle of cervical spine before and after surgery in the two groups at 3 months after surgery and the last follow-up were analyzed. Results All patients were followed up. Compared with before operation, the modified JOA score and VAS score were significantly improved in both two groups at postoperative 3 months and the last follow-up(P<0.05), there was no significant difference between the two groups(P> 0.05). The CCobb angle at the last follow-up was significantly lower in both two groups compared with before operation(P<0.05). There were no significant differences in hospital stay and operation time between the two groups(P>0.05). The intraoperative bleeding volume in PCLD group was significantly higher than that in EODL group(P<0.05). Conclusion Both two methods can improve the neural function of multilevel cervical spondylotic myelopathy, but both reduce the cervical lordosis.

关 键 词：单开门椎管成形术 全椎板切除 脊髓型颈椎病 多节段 

分 类 号：R687.3[医药卫生—骨科学]