摘要
目的探讨微型钛板固定在单开门椎管扩大椎板成形术(EOLP)治疗多节段脊髓型颈椎病(MCSM)中的临床疗效。方法对28例MCSM患者采用EOLP联合微型钛板内固定治疗,比较手术前后JOA评分和椎管矢状径评估临床疗效。结果患者均获得随访,时间9~15个月。JOA评分:术前为3~12(7.1±2.3)分,术后为9.2~16.1(12.5±2.8)分,差异有统计学意义(P<0.05)。椎管矢状径:术前为6.9~10.7(8.8±1.6)mm,术后为11.3~17.4(13.8±2.1)mm,差异有统计学意义(P<0.05);末次随访时为11.2~16.9(13.1±2.9)mm,与术后比较差异无统计学意义(P>0.05)。患者铰链侧均骨性愈合,未发生再关门现象,稳定性良好。发生C_5神经根麻痹1例,轴性症状2例,均予对症治疗后恢复或缓解。结论 EOLP治疗MCSM时应用微型钛板可有效防止再关门,利于损伤神经恢复,减少轴性症状,近期疗效满意。
Objective To investigate the clinical effect of mini-plate in expansive open-door laminoplasty（EOLP） for treatment of muhilevel cervical spondylotic myelopatby（MCSM）. Methods Mini-plate was applied to 28 cases with MCSM of EOLP. JOA and sagittal diameter of spinal canal before and after the surgery- was respectively used to evaluate the clinical effect. Results All patients were followed up for 9 - 15 months. The JOA score was 3 - 12（7.1 ± 2. 3 ） before operation and 9.2 - 16.1 （ 12.5± 2. 8 ） after operation, the difference was statistically significant（ P 〈 0. 05 ）. The sagittal diameter of spinal canal was increased from preoperative 6. 9 - 10. 7（8.8 ± 1.6） mm to postoper- ative 11.3 - 17.4（ 13.8 ±2. 1 ） ram（P〈0. 05）, at last follow-up, the sagittal diameter of spinal canal was 11.2 16. 9 （13.1 ± 2. 9） ram, there was no significantly statistical difference in above items between postoperation and last follow-up（ P 〉 0. 05 ）. All patients had bony union on the hinge side, there was no case with door re-closure and cer- vical instahility. There was 1 case developed the complication of C5 nerve root palsy, 2 cases of the axial symptom, all patients were relieved after symptomatic treatment. Conclusions Mini-plate can avoid door re-closure in the EOLP, which is beneficial to the recovery of the injured nerve and reduce the axial symptoms, the recent effect is satisfied.
出处
《临床骨科杂志》
2018年第1期8-10,共3页
Journal of Clinical Orthopaedics
关键词
脊髓型颈椎病
多节段
单开门椎板成形术
微型钛板
cervical spondylotic myelopathy
multi-segment
expansive open-door laminoplasty
titanium mini-plate
