颈椎后路单开门结合侧块螺钉治疗颈椎管狭窄伴不稳的疗效分析
发布时间：2018-08-04 09:39
【摘要】：目的观察颈椎后路单开门椎管扩大成形术结合侧块螺钉治疗颈椎管狭窄伴颈椎不稳的临床疗效。方法回顾性分析2012年5月至2015年6月收治的15例颈椎后路单开门椎管扩大成形术结合侧块螺钉治疗的颈椎管狭窄伴颈椎不稳的患者,其中男13例,女2例;年龄36～84岁,平均59.6岁。致伤原因:高处坠落伤4例,交通事故伤4例,重物砸伤2例,摔伤5例。入院后均行颈椎正侧位X线片、颈椎CT及MRI检查,均接受颈椎的后路单开门椎管扩大成形术结合侧块螺钉手术治疗。比较患者术前及术后的颈椎JOA评分、VAS评分、C2-7Cobb角和椎体前滑移距离。末次随访时同时复查颈椎活动度。结果所有患者均获得随访,随访时间为12-20月,平均15.6个月。末次随访时JOA评分、VAS评分、C2-7Cobb角和椎体前滑移距离均显著优于术前,差异有统计学意义(P0.05)。患者术后仍保留较好的颈椎活动度,未发生内固定松动、断裂等并发症。结论采用颈椎后路单开门椎管扩大成形术结合侧块螺钉治疗颈椎管狭窄伴颈椎不稳可使受压颈髓充分减压并获得较好的颈椎稳定性,是一种安全,有效的手术方式。
[Abstract]:Objective to observe the clinical effect of posterior open door laminoplasty combined with lateral mass screw in the treatment of cervical spinal stenosis with cervical instability. Methods from May 2012 to June 2015, 15 patients (13 males and 2 females) with cervical spinal stenosis associated with cervical instability treated by posterior open door laminoplasty combined with lateral mass screw were retrospectively analyzed. The average age is 59.6 years. The causes of injury were as follows: fall injury in 4 cases, traffic accident in 4 cases, heavy object injury in 2 cases and fall injury in 5 cases. After admission, all patients underwent X-ray film, CT and MRI examination. All patients were treated by posterior open door laminoplasty combined with lateral mass screw surgery. The cervical JOA scores were compared before and after operation with C 2-7 Cobb angle and anterior slip distance. At the last follow-up, the range of cervical vertebrae motion was reexamined at the same time. Results all patients were followed up for 12-20 months (mean 15.6 months). At the last follow-up, the JOA score and the C2-7 Cobb angle and the anterior slip distance of the vertebral body were significantly better than those before the operation, the difference was statistically significant (P0.05). The patient still retained good cervical mobility after operation, without internal fixation loosening, fracture and other complications. Conclusion posterior open door laminoplasty combined with lateral mass screw in the treatment of cervical spinal stenosis with cervical instability can fully decompress the compressed cervical spinal cord and obtain better cervical stability. It is a safe and effective surgical method.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
本文编号：2163436
[Abstract]:Objective to observe the clinical effect of posterior open door laminoplasty combined with lateral mass screw in the treatment of cervical spinal stenosis with cervical instability. Methods from May 2012 to June 2015, 15 patients (13 males and 2 females) with cervical spinal stenosis associated with cervical instability treated by posterior open door laminoplasty combined with lateral mass screw were retrospectively analyzed. The average age is 59.6 years. The causes of injury were as follows: fall injury in 4 cases, traffic accident in 4 cases, heavy object injury in 2 cases and fall injury in 5 cases. After admission, all patients underwent X-ray film, CT and MRI examination. All patients were treated by posterior open door laminoplasty combined with lateral mass screw surgery. The cervical JOA scores were compared before and after operation with C 2-7 Cobb angle and anterior slip distance. At the last follow-up, the range of cervical vertebrae motion was reexamined at the same time. Results all patients were followed up for 12-20 months (mean 15.6 months). At the last follow-up, the JOA score and the C2-7 Cobb angle and the anterior slip distance of the vertebral body were significantly better than those before the operation, the difference was statistically significant (P0.05). The patient still retained good cervical mobility after operation, without internal fixation loosening, fracture and other complications. Conclusion posterior open door laminoplasty combined with lateral mass screw in the treatment of cervical spinal stenosis with cervical instability can fully decompress the compressed cervical spinal cord and obtain better cervical stability. It is a safe and effective surgical method.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
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