改良的颈椎后路单开门椎管成形术的临床研究  

A clinical study on the cervical modified expansive open-door laminoplasty

作　　者：刘大勇[1] 隋国侠[1] 伦登兴[1] 厉锋[1] 徐兆万[1] 庄青山[1] 冀旭斌[1] 任国帅 LIU Da-yong;SUI Guo-xia;LUN Deng-xing;LI Feng;XU Zhao-wan;ZHUANG Qing-shan;JI Xu-bin;REN Guo-shuai(Department of Spinal Surgery,People's Hospital of Weifang City,Weifang 261041,China)

机构地区：[1]潍坊市人民医院脊柱外科,山东潍坊261041

出　　处：《中国矫形外科杂志》2022年第23期2201-2204,共4页Orthopedic Journal of China

基　　金：潍坊市科技发展计划项目(编号:2019YX006)。

摘　　要：[目的]探讨改良的颈椎后路单开门椎管成形术(expansive open-door laminoplasty, EODL)的临床效果。[方法]2019年1月—2021年6月对21例颈椎管狭窄症、多节段颈椎病患者行改良的EODL。评价临床与影像资料。[结果]21例患者均顺利完成手术,术中均无脊髓、神经、椎动脉损伤、硬膜囊撕裂,无术后C5神经根麻痹。随访12~36个月,共2例患者术后出现新发的轴性痛,发生率为9.52%;2例轴性痛患者均为轻度,术后3个月随访时轴性痛消失。与术前相比,末次随访时VAS、NDI和mJOA评分均显著改善(P<0.05)。与术前相比,末次随访时影像测量颈椎前凸角显著丢失(P<0.05),但仍保持在较理想的水平。[结论]改良的EODL是一种安全的、有效的颈椎管扩大技术,可降低术后轴性痛、C5神经根麻痹等发生率,并且能够维持较好的颈椎曲度。[Objective] To explore the clinical outcomes of posterior cervical modified expensive open-door laminoplasty(EODL).[Methods] From January 2019 to June 2021, a total of 21 patients received improved EODL for multi-level cervical spinal stenosis or cervical spondylosis. The clinical and radiographic documents were evaluated. [Results] All 21 patients had operation performed smoothly with no injuries to the spinal cord, nerve root and dural sac, and without C5nerve root palsy. During the follow-up period lasted for 12~36 months,only 2 patients of them got new-onset axial pain after operation, accounting for 9.1%, which were mild, and disappeared at 3 months postoperatively. The VAS, NDI and m JOA scores improved significantly at the latest follow-up compared with those preoperatively(P<0.05). The physiological cervical lordotic curvature decreased significantly at the latest follow-up compared with that preoperatively(P<0.05), whereas which remained in a reasonable range at the latest follow-up. [Conclusion] This modified EODL is a safe and effective technique to enlarge cervical spinal canal with advantages of reducing the incidence of postoperative axial pain and C5nerve root palsy and maintaining proper cervical curvature.

关 键 词：颈椎 改良扩大单开门椎管成形术 轴性痛 C5神经根麻痹 

分 类 号：R687[医药卫生—骨科学]