摘要
目的:研究单开门颈椎管扩大椎板成形术对颈椎运动功能的影响及相关因素。方法:对52例因脊髓型颈椎病接受单开门颈椎管扩大椎板成形术患者进行回顾性研究,平均随访37.5个月,在颈椎过屈、过伸侧位X线片上比较手术前后颈椎总的运动范围(总活动度)、各椎体间活动度。结果:术后3年颈椎总活动度、总屈曲及总仰伸角度均减小(P≤0.001),与术前相比平均下降15%,其中42例伴有颈部僵硬、疼痛等症状。颈椎总活动度的改变与神经功能的改善无相关性。各椎体间的屈伸运动范围从C2至C6均明显减小,而C6/7却稍有增加;椎体间滑移在C3/4、C4/5两个节段明显减少(P≤0.05)。结论:单开门颈椎管扩大椎板成形术可以使颈椎总活动度和各椎体间活动度均减少并伴有颈部僵硬和疼痛。术后短期围领制动并早期主动伸、屈颈部的锻炼可能有助于减少颈部僵硬和疼痛的发生。
Objective:To reveal the effect of the extensive open-door laminoplasty on the motion of cerv ical spine and the relative factors.Method:52cases of extensive open-door lamino plasty of cervical spine due to myelopathy were studied retrospectively with ave rage follow-up of37.5months.Neurological function(JOA scoring system)and pre-a nd post-operative dynamic lateral view X-rays of cervical spine were evaluated.R esult:The range of motion(ROM)and the range of flexion and extension of cervical spine reduced significantly three years after the surgical treatment(P≤0.001 ),with average of15%less than pre-operative one.42cases had pain and stiffness on the neck after the operation.There was no relationship between the change of ROM and the improvement of neurological functions.The ROM of each segment from C 2to C6reduced significantly and increased slightly at C6-7.The intervertebral sl ip of C3-4and C4-5segments reduced significantly(P≤0.05).Conclusion:The range of motion of entire cervical spine and each segment may decease after extensive open-door laminoplasty with pain and stiffness on the neck.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2003年第4期212-215,共4页
Chinese Journal of Spine and Spinal Cord
