摘要
目的推导双开门椎管扩大椎板成形术中椎板开门宽度与椎管矢状径增加值关系的公式，根据椎板开门宽度预测椎管矢状径和椎管横截面积的增加值。方法2010年9月至2013年1月期间，实施双开门椎管扩大椎板成形术治疗多节段脊髓型颈椎病20例，C3-C7节段9例，C3-C6节段11例，共89个节段。推导椎板开门宽度与椎管矢状径增加值关系的公式。根据此20例患者手术前后cT片应用pacs软件测量各项参数，应用公式预测椎板开门宽度分别为6、8、10、12、14、16mm时椎管矢状径和椎管横截面积的增加值。结果C3-C7相同节段不同椎板开门宽度时椎管矢状径增加值、椎管横截面积增加值差异均有统计学意义；C3-C。相同节段不同椎板开门宽度时各椎管矢状径增加值的差异有统计学意义；C7节段椎板开门宽度14mm与16mm时椎管矢状径增加值的差异无统计学意义；随着椎板开门宽度的增加，椎管矢状径增加值相应增加，但椎管矢状径增加值的增加趋势逐渐减弱。结论在双开门椎管扩大椎板成形术中，应用公式根据椎板开门宽度能准确预测椎管矢状径与椎管横截面积的增加值，从而指导术者进行精确地选择个体化的开门宽度，能避免过分开门或开门不足。
Objective To ratiocinate the formula of relationship between opening size of laminoplasty and the increment of sagittal canal diameter following double-door cervical laminoplasty and to predict the increment of sagittal canal diameter and the cross sectional area of canal according to the opening size of laminoplasty. Methods Twenty patients （12 males and 8 fe- males） with multilevel cervical spondylotic myelopathy had undergone double-door cervical laminoplasty （C3-C7 in 9 patients and C3-C6 in 11 patients, 89 segments） in our institution between September 2010 and January 2013. The formula describing the rela- tionship between the opening size of laminoplasty and the increment of sagittal diameter was deduced. The parameters of pre- and post-operative computed tomography scans of 20 patients who had undergone laminoplasty surgery were measured by picture ar- chiving and communication system （PACS） software, and the increment of sagittal canal diameter and the cross sectional area of ca- nal were predicted when the opening size of laminoplasty were 6 mm, 8 mm, 10 mm, 12 mm, 14 mm and 16 mm according to the formula. Results Increment of sagittal canal diameter and canal area respectively showed significant difference in the same seg- ment laminoplasty. Increment of sagittal canal diameter between various groups in the same segment （C3-C6） showed significant dif- ference. Increment of sagittal canal diameter between the opening size of 14 mm and 16 mm in C7 laminoplasty showed no signifi- cant difference. Increment of sagittal canal diameter was increased steadily following C3-C7 double-door laminoplasty with opening sizes of 6 mm, 8 mm, 10 mm, 12 mm, 14mm and 16mm, but the increasing trend in sagittal canal diameter diminished gradually. Conclusion Increment of sagittal canal diameter and canal area following C3-C7 laminoplasty can be accurately predicted ac- cording to the opening size of laminoplasty by this formula. The formula can help operator to perform double-door cervical lamino- plasty ba
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2014年第5期510-515,共6页
Chinese Journal of Orthopaedics
关键词
颈椎
减压术
外科
椎管
Cervical vertebrae
Decompression, surgical
Spinal canal
