南通大学学报（医学版）
南通大學學報（醫學版）
남통대학학보（의학판）
JOURNAL OF NANTONG UNIVERSITY(MEDICAL SCIENCES)
2014年
3期
196-198
,共3页
脊髓型颈椎病%椎管扩大成形术%单开门%微型钛板
脊髓型頸椎病%椎管擴大成形術%單開門%微型鈦闆
척수형경추병%추관확대성형술%단개문%미형태판
cervical spondylotic myelopathy%laminoplasty%single open-door%titanium miniplate
目的：探讨颈椎后路单开门椎管扩大成形术加微型钛板内固定治疗多节段脊髓型颈椎病的临床疗效。方法：选择2011年10月-2013年4月本院收治的脊髓型颈椎病15例，所有患者术前均经临床症状、X线、CT及MRI表现诊断，患者均采用颈椎后路单开门椎管扩大成形术，开门侧均使用微型钛板内固定治疗，观察术中和术后并发症发生情况，比较手术前后日本矫形外科协会(Japanese Orthopaedic Association，JOA)评分、神经功能改善率及颈椎曲度变化。结果：所有患者均顺利接受手术，手术时间70～130 min，平均85 min，术中出血量150～500 mL，平均250 mL。术中无不可逆性脊髓损伤，无脑脊液漏、切口感染、内固定断裂等并发症发生，2例患者术后出现轴性症状。随访6～20个月，平均13.4个月，JOA评分由术前平均(8.6±1.7)分提高到术后平均(13.8±2.1)分，所有患者神经功能均得到不同程度改善，神经功能改善率为28.3％～75.6％，平均(53.8±17.9)％，术后颈椎曲度为17.9°±3.8°，与术前18.1°±4.0°比较差异无统计学意义。末次随访未发现再关门现象。结论：颈椎后路单开门加微型钛板内固定术是治疗多节段脊髓型颈椎病的一种安全有效的方法。
目的：探討頸椎後路單開門椎管擴大成形術加微型鈦闆內固定治療多節段脊髓型頸椎病的臨床療效。方法：選擇2011年10月-2013年4月本院收治的脊髓型頸椎病15例，所有患者術前均經臨床癥狀、X線、CT及MRI錶現診斷，患者均採用頸椎後路單開門椎管擴大成形術，開門側均使用微型鈦闆內固定治療，觀察術中和術後併髮癥髮生情況，比較手術前後日本矯形外科協會(Japanese Orthopaedic Association，JOA)評分、神經功能改善率及頸椎麯度變化。結果：所有患者均順利接受手術，手術時間70～130 min，平均85 min，術中齣血量150～500 mL，平均250 mL。術中無不可逆性脊髓損傷，無腦脊液漏、切口感染、內固定斷裂等併髮癥髮生，2例患者術後齣現軸性癥狀。隨訪6～20箇月，平均13.4箇月，JOA評分由術前平均(8.6±1.7)分提高到術後平均(13.8±2.1)分，所有患者神經功能均得到不同程度改善，神經功能改善率為28.3％～75.6％，平均(53.8±17.9)％，術後頸椎麯度為17.9°±3.8°，與術前18.1°±4.0°比較差異無統計學意義。末次隨訪未髮現再關門現象。結論：頸椎後路單開門加微型鈦闆內固定術是治療多節段脊髓型頸椎病的一種安全有效的方法。
목적：탐토경추후로단개문추관확대성형술가미형태판내고정치료다절단척수형경추병적림상료효。방법：선택2011년10월-2013년4월본원수치적척수형경추병15례，소유환자술전균경림상증상、X선、CT급MRI표현진단，환자균채용경추후로단개문추관확대성형술，개문측균사용미형태판내고정치료，관찰술중화술후병발증발생정황，비교수술전후일본교형외과협회(Japanese Orthopaedic Association，JOA)평분、신경공능개선솔급경추곡도변화。결과：소유환자균순리접수수술，수술시간70～130 min，평균85 min，술중출혈량150～500 mL，평균250 mL。술중무불가역성척수손상，무뇌척액루、절구감염、내고정단렬등병발증발생，2례환자술후출현축성증상。수방6～20개월，평균13.4개월，JOA평분유술전평균(8.6±1.7)분제고도술후평균(13.8±2.1)분，소유환자신경공능균득도불동정도개선，신경공능개선솔위28.3％～75.6％，평균(53.8±17.9)％，술후경추곡도위17.9°±3.8°，여술전18.1°±4.0°비교차이무통계학의의。말차수방미발현재관문현상。결론：경추후로단개문가미형태판내고정술시치료다절단척수형경추병적일충안전유효적방법。
Objective:To explore the clinical efficacy of use of titanium miniplate in cervical single open-door laminoplasty for the treatment of multiple-segment cervical spondylotic myelopathy. Methods: 15 patients who stayed in our hospital were selected from October 2011 to April 2013 and diagnosed of femoral shaft fracture by clinic,X-rays,CT and MRI. All patients were underwent single open-door laminoplasty, open-door side were fixed using titanium miniplate. Surgical complications were recorded. The JOA score, improvement rate and alignment of the cervical spine were analyzed preoperative and postop-erative respectively. Results: All the patients underwent the operation. The average surgery time was 85 min ranging from 70 to 130 min. The average blood loss was 250 mL ranging from 150 to 500 mL. No complication such as irrevisible neurological injury, cerebrospinal fluid leakage, infection and break of internal fixation was noted. There were 2 patients with the occur-rence of axial symptoms. All patients were followed up 6 months to 20 months(mean, 13.4 months), the average JOA score was increased from 8.6 ±1.7 to 13.8 ±2.1. The patients with postoperative neurological deficit improved to different degrees. The JOA improvement rate was 28.3%-75.6%, with a mean of (53.8 ±17.9)%. There was no significant difference between preoperative 18.1°±4.0° and postoperative 17.9°±3.8° cervical curvature angle. No door-reclose was noted during follow- up. Conclusion:Use of titanium miniplate in cervical single open-door laminoplasty was one of safe and effective surgical method to treat multiple-segment cervical spondylotic myelopathy.
