| 摘要: |
| ［摘要］ 目的 比较观察后路颈椎管扩大成形钛板固定术与传统单开门椎管扩大成形术治疗发育性颈椎管狭窄症的临床疗效。方法 回顾分析49例发育性颈椎管狭窄症患者的临床资料，随机分为两组，其中观察组25例采用钛板固定，对照组24例采用丝线悬挂，对比分析两组患者手术情况，术后症状改善情况JOA评分，末次随访术后椎板开门角度，脊髓后移距离，术后测量颈椎曲度的改变，轴性症状发生率，以及观察手术时间、术中出血量对比情况。结果 经术后6个月～3年的随访，观察组术后6个月JOA评分改善率为（62.5±16.0）%，对照组为（59.2±9.8）%，两组比较差异无统计学意义(P>0.05)。观察组椎板开门角度为（43.6±3.5）°，对照组为（40.5±4.1）°，两组比较差异有统计学意义(P<0.05)。观察组末次随访时脊髓平均后移距离（2.97±1.8）mm，对照组为（2.96±1.7）mm，两组比较差异无统计学意义(P>0.05)。观察组术后6个月颈椎曲度为（18.6±4.8）°，与术前（18.3±4.8）°比较差异无统计学意义(P>0.05)；对照组术后6个月颈椎曲度为（17.0±5.6）°，与术前（19.9±6.2）°比较差异无统计学意义(P>0.05)；观察组术后6个月轴性症状发生率为12.0%，明显低于对照组的41.7%，两组比较差异有统计学意义(P<0.05)。两组患者无一例出现C5神经根麻痹。结论 后路颈椎管扩大成形钛板固定术与传统单开门椎管扩大成形术皆为治疗发育性颈椎管狭窄症的有效术式，但后路颈椎管扩大成形钛板固定术更能降低术后再关门及术后轴性症状的发生率，是治疗发育性颈椎管狭窄症的一种有效治疗术式。 |
| 关键词: 发育性颈椎管狭窄症 椎管成形术 单开门 钛板 |
| DOI：10.3969/j.issn.1674-3806.2017.02.07 |
| 分类号:R 68 |
| 基金项目:广西卫计委科研课题(编号:Z2013335） |
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| Comparison of the operative results between titanium miniplate in cervical expansive open-door laminoplasty and conventional cervical expansive open-door laminoplasty in treating developmental stenosis of cervical spinal canal |
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OU Yu-fu, LI Xin, WEI Min-ke, et al.
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Department of Orthopaedics, the People′s Hospital of Guangxi Zhuang Autonom ous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To compare the clinical results between titanium miniplate in cervical expansire open-door laminoplasty and conventional cervical expansire open-door laminoplasty in the treatment of the developmental stenosis of cervical spinal canal.Methods The clinical data of 49 patients with developmental stenosis of cervical spinal canal(DSCSC) were retrospectly analyzed.They were divided into two groups according to the different treatment methods.The observation group(n=25) was treated with titanium miniplate, and the control group(n=24) was treated with conventional discectomy. They were evaluated by the method of JOA, the angle of the opened laminae measured by CT or MRI scan at the final follow-up, and the incidence of axial symptoms, the cross angle between posterior vertebral body margins of C2 and C7 on cervical radiographs, the operation time and the blood loss were recorded.Results The period of follow up ranged from 6 to 36 months with an average of (10±3.1)months in the two groups.The improvement rate of JOA scores was (62.5±16.0)% in the observat group and (59.2±9.8)% in the control group six months after the operation, which showed no significant differences between the two groups(P>0.05). The angle of the opened laminae was (43.6±3.5)° in the observation group and (40.5±4.1) in the control group, which showed significant difference between the two groups(P<0.05). The posterior spinal cord shifting was (2.97±1.8)mm in the observation group and (2.96±1.7)mm in the control group,which showed no significant difference between the two groups(P>0.05). There were no significant diferences in cervical curvature angle between the observation group［(18.6±4.8)° vs (18.3±4.8)°］ and the control group［(17.0 ±5.6)° vs (19.9±6.2)°］ before and after the operation. The incidence of axial symptoms in the observation group(12.0%) was significantly lower than that in the control group(41.7%) three months after the operation(P<0.05). No case presented with C5 nerve root palsy.Conclusion Both of the two surgical protocols are effective in preventing reclose of opened laminae, however the using of titanium miniplate in cervical expansire open-door laminoplasty is superior to reducing the reclosing and recurrence of axial symptoms. |
| Key words: Developmental stenosis of cervical spinal canal Laminoplasty Open-door Titanium miniplate |
