中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2014年
11期
2608-2610
,共3页
微型钢板%多节段%脊髓型颈椎病%开门角度
微型鋼闆%多節段%脊髓型頸椎病%開門角度
미형강판%다절단%척수형경추병%개문각도
Microplate%Multi-segmental%Cervical spondylotic myelopathy%Open-door expansive laminoplasty
目的 探讨微型钢板固定法单开门椎管成形术不同椎板开门角度治疗多节段脊髓型颈椎病的临床疗效.方法 分析接受微型钢板固定法单开门椎管成形术治疗的99例多节段脊髓型颈椎病患者临床资料.依据术后CT片上测量的椎板开门角度以30°为界将患者分为两组,A组61例:开门角度15°～ 30°,B组38例:开门角度＞30°.两组患者术前一般资料比较差异无统计学意义,具有可比性.记录两组患者手术时间、术中出血量、术后第6个月JOA评分、颈椎曲度(C2～C7夹角)、C5神经根麻痹症状发生率.结果 所有患者获得随访,随访时间12～45个月(平均21.27个月).所有切口均一期愈合.所有患者术后均未出现“再关门”现象.手术时间:A组(110.13 ±13.47) min,B组(109.16±12.79) min,差异无统计学意义(P＞0.05);术中出血量:A组(150.29 ±31.64) ml,B组(152.07 ±31.37) ml,差异无统计学意义(P＞0.05);术后第6个月两组患者JOA评分比较差异无统计学意义(P＞0.05);术后第6个月两组患者颈椎曲度(C2～ C7夹角)比较差异无统计学意义(P＞0.05);C5神经根麻痹症状发生率A组为1.64％(1例),B组为7.89％(3例),差异有统计学意义(P＜0.05).结论 采用微型钢板固定法单开门椎管成形术治疗多节段脊髓型颈椎病开门角度在15°～30°时比开门角度在30°以上能获得更好的临床疗效.
目的 探討微型鋼闆固定法單開門椎管成形術不同椎闆開門角度治療多節段脊髓型頸椎病的臨床療效.方法 分析接受微型鋼闆固定法單開門椎管成形術治療的99例多節段脊髓型頸椎病患者臨床資料.依據術後CT片上測量的椎闆開門角度以30°為界將患者分為兩組,A組61例:開門角度15°～ 30°,B組38例:開門角度＞30°.兩組患者術前一般資料比較差異無統計學意義,具有可比性.記錄兩組患者手術時間、術中齣血量、術後第6箇月JOA評分、頸椎麯度(C2～C7夾角)、C5神經根痳痺癥狀髮生率.結果 所有患者穫得隨訪,隨訪時間12～45箇月(平均21.27箇月).所有切口均一期愈閤.所有患者術後均未齣現“再關門”現象.手術時間:A組(110.13 ±13.47) min,B組(109.16±12.79) min,差異無統計學意義(P＞0.05);術中齣血量:A組(150.29 ±31.64) ml,B組(152.07 ±31.37) ml,差異無統計學意義(P＞0.05);術後第6箇月兩組患者JOA評分比較差異無統計學意義(P＞0.05);術後第6箇月兩組患者頸椎麯度(C2～ C7夾角)比較差異無統計學意義(P＞0.05);C5神經根痳痺癥狀髮生率A組為1.64％(1例),B組為7.89％(3例),差異有統計學意義(P＜0.05).結論 採用微型鋼闆固定法單開門椎管成形術治療多節段脊髓型頸椎病開門角度在15°～30°時比開門角度在30°以上能穫得更好的臨床療效.
목적 탐토미형강판고정법단개문추관성형술불동추판개문각도치료다절단척수형경추병적림상료효.방법 분석접수미형강판고정법단개문추관성형술치료적99례다절단척수형경추병환자림상자료.의거술후CT편상측량적추판개문각도이30°위계장환자분위량조,A조61례:개문각도15°～ 30°,B조38례:개문각도＞30°.량조환자술전일반자료비교차이무통계학의의,구유가비성.기록량조환자수술시간、술중출혈량、술후제6개월JOA평분、경추곡도(C2～C7협각)、C5신경근마비증상발생솔.결과 소유환자획득수방,수방시간12～45개월(평균21.27개월).소유절구균일기유합.소유환자술후균미출현“재관문”현상.수술시간:A조(110.13 ±13.47) min,B조(109.16±12.79) min,차이무통계학의의(P＞0.05);술중출혈량:A조(150.29 ±31.64) ml,B조(152.07 ±31.37) ml,차이무통계학의의(P＞0.05);술후제6개월량조환자JOA평분비교차이무통계학의의(P＞0.05);술후제6개월량조환자경추곡도(C2～ C7협각)비교차이무통계학의의(P＞0.05);C5신경근마비증상발생솔A조위1.64％(1례),B조위7.89％(3례),차이유통계학의의(P＜0.05).결론 채용미형강판고정법단개문추관성형술치료다절단척수형경추병개문각도재15°～30°시비개문각도재30°이상능획득경호적림상료효.
Objective To explore the outcome of different angles of open-door expansive laminoplasty in multi-segmental cervical spondylotic myelopathy.Methods We studied 99 patients presented with multi-segmental cervical spondylotic myelopathy.All patients were treated with open-door expansive laminoplasty by microplate.According to different opening angles which were measured by CT scan after operation,the patients were divided into group A (15°-30°,61 patients) and group B (＞ 30°,38 patients).There were no significant difference of the general situations between patients from the two groups before taking treatments.Record the operation time,the mean intraoperative blood loss and JOA score,cervical curvature,incidence rates of C5 nerve root palsy six months after operation.Results All patients were followed up for an average duration of 21.27 months (range 12-45 months).All incisions were healed by first intention.No patients suffered "re-close of door".The operation time was (11O.13 ± 13.47),(109.16 ± 12.79) minutes minutes in group A,B respectively,and there are no significant difference (P ＞0.05).The mean volume of bleeding was (150.29 ±31.64) ml,(152.07 ±31.37) ml in group A,B respectively,and there are no significant difference (P ＞ 0.05).There were no significant difference when compared the JOA scores (P ＞ 0.05) and Cervical curvature (C2-C7) (P ＞ 0.05) 6 months after operations of the patients from the two groups.The incidence of C5 nerve root palsy was 1.64％,7.89％ in group A,B respectively,and there were significant difference (P ＜ 0.05).Conclusion The opening angle between 15° and 30° of open-door expansive laminoplasty by microplate can achieve a better outcome when compared witb angle above 30°.
