摘要
目的:探讨单开门椎管扩大成形术治疗氟骨性颈椎管狭窄症的效果。方法:依据影像及临床表现确诊氟骨性颈椎管狭窄症患者7例,合并后纵韧带骨化按X线分型:3例为连续型,2例为节段型,2例为混合型,全部行单开门椎管扩大成形术,常规C3￣C7减压,棘突打孔10号线固定在门轴侧侧块关节囊上。术前和术后采用日本骨科学会JOA评分(17分法)评估临床疗效。结果:2例出现脑脊液漏,均经漏口缝合、取头低脚高位、局部加压等处理痊愈,无硬膜外血肿脊髓损伤切口感染等并发症发生。3例术后2个月内发生C5神经根麻痹,经保守治疗痊愈。随访1.5￣3年,平均18.5个月,JOA评分改善率为46.2%￣87.5%(优2例,良4例,可1例),无一例复发。结论:颈后路单开门椎管扩大成形术可通过扩大椎管矢状径达到减压目的,不易损伤神经,是治疗氟骨性颈椎管狭窄症的有效方法。
Objective：To investigate the effects of posterior expansive open-door laminoplasty in the treatment of cervical spinal stenosis due to osteofluorosis.Method：From Apr 2004 to Dec 2006,7 cases with cervical spinal stenosis due to osteofluorosis confirmed by images （X-ray,CT and/or MRI） and clinical appearance were performed posterior unilateral expansive laminoplasty.Among these,there were continuous type of 3 cases ,segmental type of 2 cases and mixed type of 2 cases ,seven patients were found complicated with vertebra canal stenosis.Seven patients（4 males and 3 females） of cervical spondylotic myelopathy with cervical spinal stenosis were treated with single open-door laminoplasty at the level of C3-C7 routinely.The clinical outcomes were evaluated according to the score Japanese Orthopedic Association （JOA） before and after the operation.Result：Among them,the nerve root palsy of C5 was found in 3 cases at 2 months after operation, which improved after conservative treatment.2 cases with cerebrospinal fluid leakage were cured by means of leak suture,trendelenburg position and local pressurization,there were no extradural hematoma,spinal cord injury and wound infection after operation.Seven patients were followed up for 1.5～3 years with JOA improving rate of 46.2%～87.5%（2 excellent,4 good,1 fair）,no recurrence was notes.Conclusion：Unilateral expansive laminoplasty of cervical spine may directly expand sagittal diameter of intraspinal canal ,decompress spinal cord and keep the alignment of cervical spine which is a simple,less risk and reliable method for the treatment of fluorosis cervical stenosis.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2008年第1期37-40,共4页
Chinese Journal of Spine and Spinal Cord
关键词
氟骨症
颈椎椎管狭窄症
单开门
椎管成形术
Osteoflorosis
Cervical spinal stenosis
Unilateral expansive
Laminoplasty
