| 肖俊,唐广满.后路单开门微型钢板固定术和全椎板切除侧块螺钉固定术治疗多节段脊髓型颈椎病的对比研究.骨科,2016,7(3): 168-171. |
| 后路单开门微型钢板固定术和全椎板切除侧块螺钉固定术治疗多节段脊髓型颈椎病的对比研究 |
| Compare of the efficacy between posterior single unilateral open-door laminoplasty using mini-plate fixation and laminectomy with lateral mass screw fixation in treatment of multi-segmental cervical spondylotic myelopathy |
| 投稿时间：2015-08-10 |
| DOI：DOI：10.3969/j.issn.1674-8573.2016.03.006 |
| 中文关键词: 颈椎 脊髓压迫症 减压术，外科 椎板切除术 对比研究 |
| 英文关键词: Cervical vertebrae Spinal cord compression Decompression, surgical Laminectomy Comparative study |
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| 中文摘要: |
| 目的 比较分析椎后路单开门微型钢板固定术和全椎板切除加侧块螺钉固定术治疗多节段脊髓型颈椎病的疗效。方法 对2011年5月至2014年6月在中国人民解放军第一零一医院骨科接受治疗的65例脊髓型颈椎病患者的资料进行回顾性研究，根据手术方式分为单开门组（34例）和全椎板组（31例），比较两组患者手术前后的颈椎活动度、日本骨科协会（Japanese Orthopaedic Association, JOA）评估治疗分数及颈部轴性症状（axial symptoms, AS）发生率。结果 两组患者术后15个月的颈椎活动度均较术前下降，且单开门组的颈椎总活动度（41.25°±9.16°）大于全椎板组（33.36°±9.08°），差异具有统计学意义（t=3.340，P=0.031）；单开门组患者术后3、15个月的JOA评分为（13.26±2.34）分、（14.85±2.82）分，全椎板组患者术后3、15个月的JOA评分为（12.08±2.76）分、（12.95±2.74）分，均较术前明显提高，差异有统计学意义（均P＜0.05），但两组患者同一时间点的得分差异均无统计学意义（均P＞0.05）；全椎板组患者的AS发生率明显高于单开门组，差异有统计学意义（χ2=5.699，P=0.017）。结论 这两种手术方式均能有效改善患者的神经功能，但单开门结合微型钢板固定术的颈椎活动度损失和AS发生率更低，值得在临床上推广应用。 |
| 英文摘要: |
| Objective To compare the efficacy between posterior single expansive open-door laminoplasty with miniature plate internal fixation and total laminectomy with lateral mass screw fixation in treatment of multi-segmental cervical spondylotic myelopathy. Methods Sixty-five patients who had posterior cervical surgery in Department of Orthopaedics of the 101st Hospital of Chinese PLA from May 2011 to June 2014 were selected. They were divided into single open-door group containing 34 cases and total laminectomy group containing 31 cases according to the surgical procedures. The ranges of cervical movement (ROM), the JOA score and the axial symptoms (AS) between these two groups were compared. Results The ROM in two groups were 41.25°±9.16° and 33.36°±9.08° at 15th month (t=3.340，P=0.031). The JOA scores in two groups were 13.26±2.34 and 12.08±2.76 at 3rd month and 14.85±2.82 and 12.95±2.74 at 15th month after operation. The incidence of AS in total laminectomy group was significantly higher than that in single open-door laminoplasty group with the difference being statistically significant (χ2=5.669，P=0.017). Conclusion These two surgical procedures can effectively improve the patient’s neurological function. The single expansive open-door laminoplasty with miniature plate internal fixation treatment can retain more ROM get lower incidence of AS. It is worth to be widely used in clinic. |
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