跳跃式Centerpiece内固定在老年多节段脊髓型颈椎病中的应用

发布时间：2018-02-16 14:37

本文关键词： 多节段脊髓型颈椎病跳跃式 Centerpiece 内固定　出处：《中国老年学杂志》2016年23期 　论文类型：期刊论文

【摘要】：目的探讨颈后路单开门跳跃式Centerpiece钛板内固定在老年多节段脊髓型颈椎病中的应用及早期临床疗效。方法 2011年1月至2013年12月采用颈后路C3~C7单开门跳跃式Centerpiece钛板内固定治疗多节段脊髓型颈椎病并获得完整随访的老年患者52侧,其中男44例,女8例;年龄60~79岁,平均(68.3±5.9)岁。术前、术后1 w及6个月行日本矫形协会(JOA)评分;手术前后行颈椎X线片、CT及MRI检查,以评价术前与术后6个月颈椎Cobb角、术前与术后1 w全节段椎管矢状径大小(CT横断面上测量),钛板固定节段和非固定节段在术后1 w及术后6个月的椎管矢状径大小及门轴骨愈合情况。结果术中未出现相关并发症;术后随访8~29个月,平均16个月,神经功能均明显改善。术前JOA评分为(9.7±2.5)分,术后1 w为(13.2±1.6)分,改善率为(51.5±15.7)%。术前颈椎Cobb角与术后6个月比较差异无统计学意义(P0.05);术后1 w全节段椎管矢状径较术前显著扩大(P0.01),钛板固定节段和非固定节段的椎管矢状径大小在术后6个月较术后1 w略有缩小,但差异无统计学意义(P0.05)。术后6个月CT检查见门轴均达骨性愈合,而MRI见颈椎管扩大满意,脊髓受压基本解除。结论颈后路单开门跳跃式Centerpiece钛板内固定是治疗老年多节段脊髓型颈椎病的一种简单、安全且相对经济的方法,早期疗效较满意。
[Abstract]:Objective to investigate the application and early clinical effect of posterior cervical open door jumping Centerpiece titanium plate fixation in elderly patients with multisegmental cervical Spondylotic myelopathy. Methods from January 2011 to December 2013, the posterior cervical approach C3C7 single door jump Centerpiece titanium plate was used to treat the elderly patients with cervical Spondylotic Spondylotic Spondylotic Syndrome. 52 elderly patients with multilevel cervical Spondylotic myelopathy were treated with internal fixation and were followed up completely. There were 44 males and 8 females, aged 60 to 79 years, with an average of 68.3 卤5.9 years old. Before and after operation, JOAA score was performed at 1 week and 6 months after operation, and the cervical spine X-ray CT and MRI were performed before and after operation to evaluate the Cobb angle between preoperative and postoperative 6 months. The sagittal diameter of the whole vertebral canal before and 1 week after operation was measured on CT cross section, the sagittal diameter of vertebral canal and the union of hilar axial bone were measured at 1 week after operation and 6 months after operation with titanium plate fixation and non-fixed segment. Occurrence of related complications; The neurological function was significantly improved after 8 ~ 29 months follow-up (mean 16 months), with JOA score of 9.7 卤2.5 before operation and 13.2 卤1.6 at 1 week after operation. The improvement rate was 51.5 卤15.7%. There was no significant difference in the Cobb angle between preoperative and postoperative 6 months (P 0.05), the sagittal diameter of the whole spinal canal was significantly enlarged at 1 week after operation than that of preoperation (P 0.01), and the sagittal diameter of titanium plate fixation segment and unfixed segment was in the operation. The latter 6 months was slightly smaller than that at 1 week after operation. But the difference was not statistically significant (P 0.05). 6 months after operation, CT examination showed bony union of hilar axis, while MRI showed satisfactory cervical canal enlargement. Conclusion single open door Centerpiece titanium plate fixation is a simple, safe and economical method for the treatment of multilevel cervical Spondylotic myelopathy in the elderly.
【作者单位】：浙江省宁海第一医院;浙江大学医学院附属第二医院骨科;
【分类号】：R687.3

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