CAJ | 학술논문

目的探讨应用珊瑚人工骨作为间隔物行棘突纵割式颈椎椎管扩大成形术的效果.方法随访1995年8月至2003年12月北京积水潭医院脊柱外科142例传统应用珊瑚人工骨作为间隔物手术和147例保留颈2和颈7棘突肌肉止点的应用珊瑚人工骨作为间隔物手术做至少3个月的随访,通过回顾性研究对临床效果、颈椎曲度、合并症、颈椎活动度、手术时间和失血量作对比研究所有的统计数据采用SPSS 13.0进行相关性分析.结果两组手术在临床效果和出血量没有显著性差异,改良组在手术时间减少(t =2.56,P＜0.05独立样本t检验),颈椎生理曲度和颈椎活动度保持更好(t=-2.314,P＜0.05),颈椎手术后的轴性症状发生率低(t=-2.314,P＜0.05).结论在颈椎后路手术中,减少肌肉损害能够降低手术并发症.保留主要肌肉止点可以使颈椎保持良好的生理曲度,减少轴性症状的发生率.
목적 탐토응용산호인공골작위간격물행극돌종할식경추추관확대성형술적효과.방법 수방1995년8월지2003년12월북경적수담의원척주외과142례전통응용산호인공골작위간격물수술화147례보류경2화경7극돌기육지점적응용산호인공골작위간격물수술주지소3개월적수방,통과회고성연구대림상효과、경추곡도、합병증、경추활동도、수술시간화실혈량작대비연구소유적통계수거채용SPSS 13.0진행상관성분석.결과 량조수술재림상효과화출혈량몰유현저성차이,개량조재수술시간감소(t =2.56,P＜0.05독립양본t검험),경추생리곡도화경추활동도보지경호(t=-2.314,P＜0.05),경추수술후적축성증상발생솔저(t=-2.314,P＜0.05).결론 재경추후로수술중,감소기육손해능구강저수술병발증.보류주요기육지점가이사경추보지량호적생리곡도,감소축성증상적발생솔.
Objective To explore the outcomes of longitudinal spinous splitting laminoplasty with coral bone (abbreviated as SLAC) for cervical stenosis.Methods A total of 142 patients underwent conventional SLAC while 147 other patients modified SLAC.Assessments were made at pre-operation,postoperation and 3-month follow-up to examine the effects of two surgical approaches on the recovery rate of JOA (Japanese Orthopedic Association) score.The change of cervical alignment,change of cervical motions,axial syndrome,operative duration and intra-operative blood loss were recorded and analyzed with SPSS 13.0.Results No significant difference existed between two groups in the recovery rate of JOA score and intra-operative blood loss.The smaller change of cervical alignment and change of cervical motions were found in the modified SLAC group.The modified SLAC group had fewer patients with axial syndrome during the follow-up period. The operative duration was shorter in the modified SLAC group. Conclusion Preventing muscle injuries in cervical laminoplasty can reduce the incidence of complications.The modified SLAG approach may protect cervical posterior extensor musculature,maintain the cervical lordotic alignment and reduce the incidence of post-operative axial syndrome.