不同椎管扩大成形术治疗颈椎椎管狭窄的近期效果  

Short-Term Effect of Different Laminoplasty Techniques for the Treatment of Cervical Spinal Stenosis

作　　者：刘松[1] 姜岩[1] 滕元平 LIU Song;JIANG Yan;TENG Yuanping(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院骨科,河南郑州450000

出　　处：《河南医学研究》2025年第5期869-872,共4页Henan Medical Research

摘　　要：目的比较内镜下微创颈椎管扩大成形术(CMEL)以及颈后路单开门手术(EOLP)治疗颈椎管狭窄的近期效果。方法选取2016年3月至2021年2月郑州大学第一附属医院骨科收治的60例颈椎椎管狭窄患者的临床及影像学资料,其中对称减压组30例患者接受CMEL治疗,对照组30例患者接受EOLP治疗。采用日本骨科协会(JOA)评分和颈椎功能障碍指数(NDI)分别评估临床疗效及生活质量。比较两组手术时间、术中出血量,术前、术后3个月、末次随访时狭窄部颈椎管矢状径、JOA及NDI。结果对比两组围手术期资料,对称减压组手术时间及术中出血量低于对照组,差异有统计学意义(P<0.05);术后3个月、末次随访时两组的JOA评分、NDI差异无统计学意义(P>0.05)。术后3个月、末次随访时对称减压组颈椎管矢状径高于对照组(P<0.05)。结论内镜下微创颈椎管扩大成形术与颈后路单开门椎管扩大减压术比较,手术时间较短,术中出血量较少,其扩大颈椎管矢状径效果更优秀且能维持颈椎管结构稳定,有效促进颈椎及神经功能恢复。Objective Compare the short-term efficacy of cervical microendoscopic laminoplasty(CMEL)and cervical expansive open-door laminoplasty(EOLP)in the treatment of cervical spinal stenosis.Methods The clinical and radiological data of 60 patients with cervical spinal stenosis admitted to the Orthopedics Department of the First Affiliated Hospital of Zhengzhou University from March 2016 to February 2021 were selected.Thirty patients underwent cervical microendoscopic laminoplasty(CMEL)as the symmetric decompression group,while the other 30 patients received cervical expansive open-door laminoplasty(EOLP)as the control group.The clinical efficacy and quality of life were evaluated using the Japanese Orthopaedic Association(JOA)score and the neck disability index(NDI),respectively.The operative time,intraoperative blood loss,sagittal diameter of the narrowed cervical canal,JOA score,and NDI were compared between the two groups before surgery,3 months after surgery,and at the last follow-up.Results Compared with the single open-door group,the operative time and intraoperative blood loss in the the symmetric decompression group were lower,and the difference was statistically significant(P<0.05).There was no significant difference in JOA score and NDI between the two groups at 3 months after surgery and at the last follow-up(P>0.05).The sagittal diameter of cervical canal in the the symmetric decompression group was higher than that in the control group at 3 months after surgery and at the last follow-up(P<0.05).Conclusion Compared with cervical expansive open-door laminoplasty for spinal canal decompression,cervical microendoscopic laminoplasty has a shorter operative time and less intraoperative blood loss.It achieves better sagittal diameter expansion of the cervical canal and maintains the stability of the cervical canal structure,effectively promoting the recovery of cervical spine and neurological function.

关 键 词：颈椎管狭窄 对称减压 颈椎功能 神经功能 

分 类 号：R68[医药卫生—骨科学]