改良椎板悬吊单开门椎管成形术治疗多节段颈椎病的疗效观察

发布时间：2018-10-08 21:45

【摘要】：[目的]评价改良椎板悬吊单开门椎管成形术治疗多节段颈椎病合并颈椎不稳的疗效。[方法]回顾性分析2012年5月~2014年10月收治的38例多节段颈椎病合并颈椎不稳的患者,男25例,女13例;年龄42~67岁,平均52.6岁。所有患者接受改良椎板悬吊单开门椎管成形联合侧块螺钉内固定术,术后评估颈椎JOA评分、颈部VAS评分改善及椎板开门角度变化情况,并分析记录并发症。[结果]手术时间(136±34)min,出血量(324±78)ml。平均随访27.3月(13~42月),术前JOA评分(9.64±2.38),术后提高至(14.62±3.21)(t=-12.96,P0.01),JOA改善率67.66%。术前颈部VAS评分(6.37±2.16),术后降低至(3.25±2.41)(t=9.72,P0.01)。术后1周颈椎开门角度46.41°±9.32°,末次随访时43.27°±8.82°,差异无统计学意义(t=1.64,P=0.11)。术后5例(13.2%)患者出现轴性症状,3例(7.9%)患者出现C5神经麻痹。[结论]改良椎板悬吊单开门椎管成形术治疗多节段颈椎病合并颈椎不稳,明显提高了患者神经功能,较好的维持了术后开门角度,早期效果满意。
[Abstract]:[objective] to evaluate the effect of modified lamina suspension single door laminoplasty in the treatment of multiple cervical spondylosis with cervical instability. [methods] from May 2012 to October 2014, 38 patients with multilevel cervical spondylosis complicated with cervical instability were retrospectively analyzed, including 25 males and 13 females, aged 42 to 67 years (mean 52.6 years). All patients were treated with modified lamina suspension single door laminectomy combined with lateral mass screw fixation. The cervical JOA score, cervical VAS score improvement and laminar open door angle change were evaluated after operation. Complications were analyzed and recorded. [results] the operative time was (136 卤34) min, and the amount of bleeding was (324 卤78) ml.. The average follow-up was 27.3 months (13-42 months), the preoperative JOA score was (9.64 卤2.38), and the postoperative JOA score was increased to (14.62 卤3.21) (t-12.96 卤P0.01). The cervical VAS score was (6.37 卤2.16) before operation and (3.25 卤2.41) after operation (t = 9.72 卤P0.01). The cervical open door angle was 46.41 掳卤9.32 掳at 1 week postoperatively and 43.27 掳卤8.82 掳at the last follow-up. There was no significant difference (t 1.64 卤0.11). Axonal symptoms were found in 3 patients (7.9%) and C5 nerve palsy was found in 5 patients (13.2%). [conclusion] modified laminar suspension single door laminoplasty for the treatment of multilevel cervical spondylosis with cervical instability can significantly improve the neurological function of the patients and maintain the postoperative open door angle. The early results are satisfactory.
【作者单位】：中日友好医院脊柱外科;北京协和医学院研究生院;
【基金】：首都临床特色应用研究项目(编号:Z141107002514058)
【分类号】：R687.3

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