CAJ | 학술논문

背景：郑州大学第一附属医院骨科近年开展一项微创微型钛板置入颈椎管成形治疗脊髓型颈椎病，在保留颈椎重要结构的基础上对颈椎病实现脊髓减压。 　　目的：对比分析微创微型钛板置入颈椎管成形与颈后路单开门椎管扩大成形对脊髓型颈椎病的治疗效果。 　　方法：将78例脊髓型颈椎病患者随机分成2组，分别采用微创微型钛板置入颈椎管成形与颈后路单开门椎管扩大成形治疗。 　　结果与结论：治疗后随访3-36个月。末次随访患者日本骨科学会(JOA)评分优良率两组差异无显著性意义(P>0.05)。治疗后轴性症状明显率微创颈椎管成形组明显低于单开门组(P<0.05)，颈曲指数丢失值微创颈椎管成形组显著低于单开门组(P<0.05)。微创颈椎管成形组末次随访1例患者2枚钛钉轻微松动，患者无异常症状。单开门组治疗中6例开门时出现铰链侧断裂，将断裂椎板切除，脊髓表面覆盖人工硬脊膜加以保护。结果表明，微创颈椎管成形组与单开门组相比在脊髓功能恢复方面疗效无差别，但治疗后并发症远低于单开门组。
배경：정주대학제일부속의원골과근년개전일항미창미형태판치입경추관성형치료척수형경추병，재보류경추중요결구적기출상대경추병실현척수감압。 　　목적：대비분석미창미형태판치입경추관성형여경후로단개문추관확대성형대척수형경추병적치료효과。 　　방법：장78례척수형경추병환자수궤분성2조，분별채용미창미형태판치입경추관성형여경후로단개문추관확대성형치료。 　　결과여결론：치료후수방3-36개월。말차수방환자일본골과학회(JOA)평분우량솔량조차이무현저성의의(P>0.05)。치료후축성증상명현솔미창경추관성형조명현저우단개문조(P<0.05)，경곡지수주실치미창경추관성형조현저저우단개문조(P<0.05)。미창경추관성형조말차수방1례환자2매태정경미송동，환자무이상증상。단개문조치료중6례개문시출현교련측단렬，장단렬추판절제，척수표면복개인공경척막가이보호。결과표명，미창경추관성형조여단개문조상비재척수공능회복방면료효무차별，단치료후병발증원저우단개문조。
BACKGROUND:In recent years, a single-door laminoplasty for cervical spondylotic myelopathy was performed in the Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University. This surgery achieved spinal decompression while remaining the important structure of cervical vertebra. OBJECTIVE:To comparatively analyze the therapeutic effects of minimal y invasive cervical laminoplasty and single-door laminoplasty on cervical spondylotic myelopathy. METHODS:A total of 78 cases of cervical spondylotic myelopathy were randomly divided into two groups, which respectively received minimal y invasive cervical laminoplasty and single-door laminoplasty. RESULTS AND CONCLUSION:Al cases were fol owed-up for 3-36 months. No significant difference in excellent and good rate of Japanese Orthopaedic Association score was detected between the two groups in final fol ow-up (P>0.05). The apparent rate of axial symptoms was significantly lower in the minimal y invasive cervical laminoplasty group than that in the single-door laminoplasty group after treatment (P<0.05). Cervical curvature loss was significantly lower in the minimal y invasive cervical laminoplasty group than that in the single-door laminoplasty group (P<0.05). In final fol ow-up, in the minimal y invasive cervical laminoplasty group, two titanium screws of one patient were slightly loose, and no abnormal symptom was observed. In the single-door laminoplasty group, hinge breakage was visible in six patients. The broken vertebral plate was excised. Artificial spinal dura mater was coated on the surface of spinal cord for protection. Results suggested that the effect of two surgical methods in promoting functional recovery of spinal cord is identical. However, complications in the minimal y invasive cervical laminoplasty group are further fewer than those in the single-door laminoplasty group.