摘要
目的探讨后路单开门颈椎管扩大成形术治疗脊髓型颈椎病(Cervical SpondyloticMyelopathy,CSM)时,采用锚定法与Arch钢板内固定的疗效是否有明显差异。方法回顾性分析了自2012-09-2015-03采用颈椎后路椎管扩大成形术治疗的70例CSM患者,依据开门侧固定方案的不同,将其分为Arch钢板组37例和锚定组33例,对两组患者的术后相关指标进行对比。结果 70例患者均顺利完成手术,两组手术时间和术中出血量无显著性差异(P>0.05);在JOA评分改善率方面,Arch钢板组术后24个月显著优于锚定组(P<0.05);Arch钢板组的椎管扩大率为(54.1±15.2)%,显著高于锚定组的(37.6±11.8)%,差异有统计学意义(P<0.05)。术后轴性症状对比,Arch钢板组仅发生3例,发生率为8.1%,显著少于锚定组的8例(24.2%),差异有统计学意义(P<0.05)。结论两种术式行颈椎单开门椎管扩大成形术,均可取得良好的疗效,但Arch钢板固定术后不易发生开门后再丢失现象,其轴性症状发生率更低,且远期JOA评分改善效果更佳。
Objective To compare the effects of cervical laminoplasty with anchor method andArch plate fixation in the treatment of cervical spondylotic myelopathy （CSM）. Methods A retrospectiveanalysis of 70 patients with CSM who received the posterior cervical laminoplasty treatment fromSeptember 2012 to March 2015 was conducted. According to the open side fixed scheme, the patientswere divided into Arch plate group（37 cases） and the anchor group （33 cases）. The related postoperativeindicators were compared between the two groups. Results All 70 patients were successfully completedsurgery, there were no significant differences in operation time and bleeding volume during operationbetween the two groups （P〉0.05）. The improvement rate of JOA score in Arch plate group at 24 monthsafter operation was significantly higher than that of the anchoring group （P〈0.05）. The spinal canal rateof the Arch plate group was （54.1±15.2）%, which was significantly higher than （37.6±11.8）% of theanchoring group, the difference was statistically significant （P〈0.05）. After operation, there were 3 casesin the Arch plate group had axial symptoms, the incidence rate was 8.1%, which was significantly lowerthan that in the anchoring group （8 cases, 24.2%）, and the difference was statistically significant（ P〈0.05）. Conclusion Two surgical methods of cervical laminoplasty, can achieve good effect, but theArch plate fixation is not easy to open the door after the loss, the incidence of axial symptoms is lower,and the long-term JOA score improved better.
作者
杜东升
DU Dong-sheng(General Hospital of Fuxin Mining（Group）Co.,Ltd.,Fuxin,Liaoning 123000,China)
出处
《颈腰痛杂志》
2018年第6期751-753,757,共4页
The Journal of Cervicodynia and Lumbodynia
