后路单开门联合单侧钉棒固定治疗多节段颈椎管狭窄症合并创伤性颈脊髓损伤的疗效  

The efficacy of posterior single open-door laminoplasty combined with unilateral nail rod fixation in the treatment of cervical spinal stenosis and traumatic cervical spinal cord injury

作　　者：刘晓印 张建群[1] 陈振[2] 梁思敏[1] 吴鹏[1] 马宗军[1] 马荣[2] 戈朝晖[1] LIU Xiaoyin;ZHANG Jianqun;CHEN Zhen;LIANG Simin;WU Peng;MA Zongjun;MA Rong;GE Zhaohui(Department of Orthopaedics,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院骨科,宁夏银川750004 [2]宁夏医科大学,宁夏银川750004

出　　处：《宁夏医学杂志》2024年第10期841-844,F0002,共5页Ningxia Medical Journal

基　　金：宁夏重点研发项目(2023BEG02017)。

摘　　要：目的观察后路单开门椎板成形联合单侧侧块钉棒固定治疗多节段颈椎管狭窄症合并创伤性颈脊髓损伤的临床疗效。方法回顾性分析多节段颈椎管狭窄症合并创伤性颈脊髓损伤的26例患者的病例资料,所有患者均采用后路单开门椎板成形联合单侧侧块钉棒固定手术治疗。记录患者手术时间、术中出血量及术后并发症一般情况;采用视觉模拟评分(VAS)评估颈痛情况,采用日本骨科学会(JOA)评分、JOA改善率评价临床症状及神经功能状态恢复情况。结果患者随访时间为24~62个月,平均为(34.5±9.8)个月,术后6个月、末次随访JOA、VAS评分均较术前获得明显改善(P<0.05);术后无内固定失败、螺钉松动及不稳加重,无脊髓及神经根损伤;1例患者出现脑脊液漏,1例患者出现皮下切口脂肪液化,1例患者出现轴性症状,对症处理后预后良好。结论对于多节段颈椎管狭窄症合并创伤性颈脊髓损伤的患者,后路单开门椎板成形联合单侧侧块钉棒固定可以获得良好的临床效果并维持颈椎稳定。Objective To observe the clinical efficacy of posterior single open-door laminoplasty combined with unilateral nail rod fixation in the treatment of multilevel cervical spinal stenosis and traumatic spinal cord injury.Methods The data of 26 patients with multilevel cervical spinal stenosis and traumatic cervical spinal cord injury were collected and analyzed retrospectively.All patients were treated with posterior single open-door laminoplasty combined with unilateral lateral mass nail rod fixation.The operation time,intraoperative blood loss and postoperative complications were recorded.The visual analogue scale(VAS)was used to assess neck pain,the Japanese Orthopaedic Society(JOA)score and JOA improvement rate was used to evaluate clinical symptoms and recovery of neurological function.Results The patients were followed up for 24 to 62 months,with an average of(34.5±9.8)months.The JOA and VAS scores were significantly improved at 6 months after surgery and at the last follow-up(P<0.05).There was no failure of internal fixation,screw loosening,aggravation of instability,spinal cord and nerve root injury.One patient had cerebrospinal fluid leakage,and one had fat liquefaction of subcutaneous incision.One patient had axial symptom,the prognosis was good after symptomatic treatment.Conclusion For patients with multilevel cervical spinal stenosis and traumatic cervical spinal cord injury,posterior single open-door laminoplasty combined with unilateral lateral mass nail rod fixation can achieve good clinical results and maintain cervical spine stability.

关 键 词：颈椎管狭窄 颈脊髓损伤 侧块钉棒 

分 类 号：R687.3[医药卫生—骨科学]