摘要
目的探讨多节段脊髓型颈椎病(multi-segment cervical spondylotic myelopathy,MCSM)单开门椎管扩大成形术(expansive single open-door laminoplasty,EOLP)术中应用纳米骨板固定的疗效和影响因素。方法选取2018年5月~2020年6月诊治的84例MCSM患者临床资料进行回顾性分析,均予以EOLP纳米骨板固定,依照末次随访结果评估治疗效果,根据JOA改善率分为A组(JOA改善率≥50%,n=59)与B组(JOA改善率<50%,n=25),分析影响JOA改善率的相关因素。结果84例随访优良率为70.24%,术后7 d的C5节段椎管矢状径大于术前(P<0.05),术后7 d、术后12个月的JOA评分高于术前(P<0.05)。两组在性别、年龄、压迫节段、术前JOA评分比较中,差异无统计学意义(P>0.05);而在病程、术前Yukawa信号等级分级、术前脊髓受压段横断面积、术前脊髓受压比、术前最大脊髓受压程度(maximum spinal cord compression,MSCC)、术前最大椎管容积(maximum canal compromise,MCC)比较中,差异存在统计学意义(P<0.05)。二分类Logistic回归分析显示,病程≥6个月、术前Yukawa信号等级分级为2级/1级、术前脊髓受压段横断面积、术前脊髓受压比、术前MSCC、术前MCC是影响MCSM患者JOA改善率的独立危险因素(P<0.05)。Spearman相关性分析显示,术前Yukawa信号分级与术前MSCC、术前MCC呈正相关(r=0.289/0.234,P<0.05)。结论EOLP纳米骨板固定治疗多节段脊髓型颈椎病能改善颈椎功能,病程≥6个月、术前Yukawa信号分级为2级/1级、术前脊髓受压段横断面积、术前脊髓受压比、术前MSCC、术前MCC是影响MCSM患者JOA改善率的独立危险因素。
Objective To explore the efficacy and influencing factors of multi-segment cervical spondylotic myelopathy(MCSM)in expansive single open-door laminoplasty(EOLP)nanoplate fixation.Methods The clinical data of 84 MCSM patients diagnosed and treated from May 2018 to June 2020 were selected for retrospective analysis,and they were all fixed with EOLP nanoplates.The treatment effect was evaluated according to the results of the last follow-up,and they were divided into group A(JOA improvement rate≥50%,n=59)and group B(JOA improvement rate<50%,n=25),then the relevant factors affecting the JOA improvement rate were analyzed.Results The excellent and good rate of follow-up in 84 cases was 70.24%.The sagittal diameter of the C 5 spinal canal seven days after operation was greater than that before operation(P<0.05),and the JOA score seven days after operation and twelve months after operation was higher than that before operation(P<0.05).There was no significant difference between the two groups in gender,age,compressed segment,and preoperative JOA score(P>0.05).There were significant differences in the anterior spinal cord compression ratio,maximum spinal cord compression(MSCC),and maximum canal compromise(MCC)(P<0.05).Binary logistic regression analysis showed that the disease duration≥6 months,the preoperative Yukawa signal grade was grade 2/1,the preoperative spinal cord compression segment cross-sectional area,the preoperative spinal cord compression ratio,the preoperative MSCC,and the preoperative MCC were independent risk factors affecting the improvement rate of JOA in MCSM patients(P<0.05).The Spearman method showed that the preoperative Yukawa signal grade was positively correlated with preoperative MSCC and preoperative MCC(r=0.289/0.234,P<0.05).Conclusion EOLP nanoplate fixation can improve the function of cervical spine in multi-segment cervical spondylotic myelopathy,and the course of disease is≥6 months,the preoperative Yukawa signal grade is grade 2/1,and the cross-sectional area of the preoperative s
作者
董征
未东兴
段大波
DONG Zheng;WEI Dong-xing;DUAN Da-bo(Orthopedics Department,Jinzhou Central Hospital,Jinzhou,Liaoning 121000,China)
出处
《颈腰痛杂志》
2024年第2期315-319,共5页
The Journal of Cervicodynia and Lumbodynia
关键词
Y型纳米骨板
单开门椎管扩大成形术
多节段脊髓型颈椎病
Y-type nano bone plate
expansive single open-door laminoplasty
multi-segment cervical spondylotic myelopathy
