带线锚钉与微钛板固定对颈椎单开门椎管扩大成形术后门轴侧椎板骨愈合的影响

发布时间：2018-06-05 10:37

本文选题：颈椎病 + 带线锚钉　；参考：《现代中西医结合杂志》2016年19期

【摘要】：目的探讨带线锚钉与微钛板固定对颈椎单开门椎管扩大成形术后门轴侧椎板骨愈合的影响。方法回顾性研究采用颈椎单开门术治疗的脊髓型颈椎病56例,根据内固定方式分为锚钉组和微钛板组,其中锚钉组21例,共开门105个椎板,微钛板组35例,共开门175个椎板。评估2组术后临床症状、神经功能和颈椎活动度的改变。根据术后3 d CT评估术后门轴椎板的骨折情况,分为门轴骨折移位组和门轴骨折无移位组;根据术后3个月和6个月的CT评估门轴的骨愈合情况。结果 2组术后3个月和6个月JOA评分较术前明显提高(P均0.05),而2组间JOA评分及神经功能改善率比较差异无统计学意义(P均0.05)。微钛板组术后6个月ROM及VAS评分优于锚钉组(P均0.05)。微钛板组术后3个月总体骨愈合率高于锚钉组(P0.05),2组术后6个月总体骨愈合率比较差异无统计学意义(P0.05);微钛板组门轴骨折无移位亚组术后3个月骨愈合率高于锚钉组(P0.05),术后6个月2组差异无统计学意义(P0.05),微钛板组骨折移位亚组术后3个月及术后6个月骨愈率均高于锚钉组(P均0.05)。结论相对于带线锚钉固定法,微钛板固定法对单开门术后门轴的稳定性和骨愈合作用更佳,两者在神经功能改善方面无差异。
[Abstract]:Objective to investigate the effect of wire anchor nail and microtitanium plate fixation on the union of axial laminar bone in cervical open door laminoplasty. Methods 56 cases of cervical Spondylotic myelopathy treated by single open door cervical vertebra were retrospectively studied. According to the internal fixation, 56 cases were divided into two groups: the anchor nail group (21 cases), the open door laminae group (35 cases) and the microtitanium plate group (35 cases). To evaluate the changes of clinical symptoms, neurological function and cervical mobility after operation in both groups. According to the CT data of 3 days after operation, the patients were divided into two groups: the displaced group and the non-displaced group, and the bone union of the portal axis was evaluated by CT at 3 and 6 months after operation. Results the JOA scores of the two groups increased significantly 3 and 6 months after operation (P < 0.05), but there was no significant difference between the two groups in the scores of JOA and the improvement rate of nerve function (P < 0.05). The ROM and VAS scores in the microtitanium plate group were better than those in the anchor nail group at 6 months after operation (P < 0.05). There was no significant difference in the total bone healing rate between the microtitanium plate group and the anchor nail group at 3 months postoperatively, and the total bone healing rate in the titanium microplate group was higher than that in the anchor nail group at 3 months after operation, and the total bone union rate in the titanium microplate group was higher than that in the anchor nail group at 3 months after operation. There was no significant difference between the two groups at 6 months after operation (P 0.05). The recovery rate of bone in the microplate group was higher than that in the anchor nail group at 3 months after operation and 6 months after operation (P < 0.05). Conclusion compared with wire anchor nail fixation, microtitanium plate fixation has better effect on stability and bone healing of portal axis after single door opening operation, and there is no difference in the improvement of nerve function between the two methods.
【作者单位】：河北省邯郸市中心医院;
【分类号】：R687.3

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