改良颈椎单开门椎管扩大术联合Y型纳米骨板内固定治疗脊髓型颈椎病  

The modified cervical single open-door spinal canal enlargement combined with Y-type nano bone-plate internal fixation for cervical spondylotic myelopathy

作　　者：卢志有 钟伟建 郭惠红 LU Zhi-you;ZHONG Wei-jian;GUO Hui-hong(Dept of Orthopaedics,the First People′s Hospital of Nankang District of Ganzhou City,Ganzhou,Jiangxi 341400,China)

机构地区：[1]赣州市南康区第一人民医院骨科,江西赣州341400

出　　处：《临床骨科杂志》2024年第4期457-460,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨改良颈椎单开门椎管扩大术联合Y型纳米骨板内固定治疗脊髓型颈椎病的疗效。方法采用改良颈椎单开门椎管扩大术联合Y型纳米骨板内固定治疗35例脊髓型颈椎病患者。记录手术情况及并发症发生情况,采用JOA评分评价患者颈椎轴性症状及脊髓功能恢复情况。结果手术时间70~135(95.6±16.5)min,术中出血量100~250(180.5±22.4)ml。患者均获得随访,时间6~24(13.5±1.9)个月。切口均一期愈合。术中均未出现神经根、硬膜、脊髓损伤及医源性门轴侧椎板断裂,术后均未发生脑脊液漏、硬膜外血肿形成、切口感染及颈椎生理反曲等并发症。术后X线检查显示内固定位置良好,未出现松动、断板及断钉等现象,椎管扩大明显,脊髓未再受压,未出现再关门现象。JOA评分术后2周、末次随访均较术前改善(P<0.05)。结论改良颈椎单开门椎管扩大术联合Y型纳米骨板内固定治疗脊髓型颈椎病可避免出现再关门现象,降低轴性症状发生率,并发症少,脊髓功能恢复较好。Objective To investigate the effect of modified cervical single open-door spinal canal enlargement combined with Y-type nano bone-plate internal fixation for treatment of cervical spondylotic myelopathy.Methods The 35 patients with cervical spondylotic myelopathy were treated by modified cervical single open-door spinal canal enlargement combined with Y-type nano bone-plate internal fixation.The operative conditions and complications were recorded,the cervical axial symptoms and spinal cord functional recovery were evaluated by JOA scores.Results The operative time was 70~135(95.6±16.5)min,and the blood loss volume was 100~250(180.5±22.4)ml.All patients were followed up for 6~24(13.5±1.9)months.All incisions healed in one-stage.There were no nerve root,dural and spinal cord injuries or iatrogenic axial laminae rupture.There were no postoperative complications such as cerebrospinal fluid leakage,epidural hematoma formation,incision infection and cervical physiological inversion.Postoperative X-ray examination showed that the internal fixation position was good,and no loosening,plate fracture or screw fracture occurred.The spinal canal was enlarged significantly,the spinal cord was not re-compressed,and no re-closing occurred.Compared with the preperation,the JOA score was improved at postoperative 2 weeks and the last follow-up(P<0.05).Conclusions Modified cervical single open-door vertebral canal enlargement combined with Y-type nano bone-plate internal fixation can avoid the re-closing phenomenon,reduce the incidence rate of axial symptoms,with few complications,and better spinal cord function recovery.

关 键 词：颈椎病 Y型纳米骨板 改良颈椎单开门 

分 类 号：R681.57[医药卫生—骨科学] R687.3[医药卫生—外科学]