摘要
目的:探讨颈后路单开门联合key-hole减压植骨融合内固定术治疗多节段脊髓神经根型颈椎病(CRM)的手术疗效。方法:回顾性分析2015年6月-2017年12月在我科行颈后路单开门联合key-hole减压植骨融合内固定术的24例CRM患者临床资料,记录术前、术后随访JOA评分,VAS评分,颈椎曲度变化及并发症情况。结果:随访时间12-18个月(14.23±3.25个月)。术后1周.6个月及12个月JOA评分、VAS评分较术前明显改善(P<0.05);术后1周6个月及12个月颈椎曲度较术前明显增大(P<0.05);术后6个月及术后12个月与术后1周比较,JOA评分,VAS评分及颈椎曲度无显著差异。8例术前颈椎曲度变直患者术后6例恢复正常序列;术前双下肢无力,踩棉花感19例患者术后行走能力均增强;神经根性疼痛消失16例,显著改善8例;术前2例排尿排便患者均改善。术后出现脑脊液漏1例。结论:颈后路单开门联合key-hole减压植骨融合内固定术治疗CRM,可充分缓解脊髓和神经根症状,术后颈椎曲度改善明显,轴性症状、Cs神经根瘫、颈椎失稳等并发症发生率低,不失为一种安全有效的手术方式。
Objective:To evaluate the clinical effects of single open-door laminoplasty with key-hole decompression and internal fixation on patients with multi-level cervical radiculomyelopathy(CRM)。Methods:Data of 24 CRM patients from June 2015 to December 2017 were collected retrospectively.The JOA scores,VAS scores,image data and complications were investigated.Results:All patients were followed up for 12 to 18 months(14.32±32.5 months).The 1-week post-operation,6-month post-operation and 12-month operation JOA,VAS and cervical cobb angle were significantly better than pre-operation,respectively(P<0.05).The 6-month post-operation and 12-month operation JOA,VAS and cervical cobb angle had no significantly difference with 1-week postoperation(P>0.05).8 patients with straight cervical curvature restored normal balance.19 cases with weakness of lower limbs regained walk ability.16 cases showed no nerve root pain and 8 patients showed less nerve root pain after operation.2 patients with per-operation disorder of dysuria and defecation improved obviously.There was 1 patients identified cerebrospinal fluid leakage after operation.Conclusion:Single open-door laminoplasty with key-hole decompression and intemal fixation demonstrates effective and safe clinical outcomes on CRM patients.This method could relieve significantly nerve root and cord compression,and showed low incidence of axial syndrome,C5 palsy and cervical instability.
作者
徐政
张尧
XU Zheng;ZHANG Yao(Yangzhou first People hospital aliated of Yangzhou university,Yangzhou 225002)
出处
《中国伤残医学》
2021年第17期5-7,共3页
Chinese Journal of Trauma and Disability Medicine
