CAJ | 학술논문

目的：比较多节段颈脊髓病2种后路手术方式的临床疗效。方法回顾分析80例因多节段颈脊髓病行椎板成形术（A组）和椎板切除融合术（B组）的患者的资料，对2组患者术前、术后及随访时影像学资料和临床评价指标进行比较。结果术后1周2组日本骨科学会（ Japanese Orthopaedic Association ， JOA）评分平均改善率差异无统计学意义（P＞0．05），A组疼痛视觉模拟量表（visual analogue scale， VAS）评分、颈椎曲度与术前相比差异无统计学（P＜0．05），B组则显著改善（P＜0．05）。术后1年B组JOA评分较术后1周显著降低（P＜0．05），B组与术前颈椎活动度的差值显著大于A组（P＜0．01）。随访期间，A组C5神经麻痹的发生率为2．8％（1/36），B组为12．5％（3/24），差异有统计学意义（χ2＝3．35，P＜0．05）。结论2种方法早期都可取得良好的神经功能改善，在颈椎曲度、颈痛和活动度的影响上，两者各有优劣。
목적：비교다절단경척수병2충후로수술방식적림상료효。방법회고분석80례인다절단경척수병행추판성형술（A조）화추판절제융합술（B조）적환자적자료，대2조환자술전、술후급수방시영상학자료화림상평개지표진행비교。결과술후1주2조일본골과학회（ Japanese Orthopaedic Association ， JOA）평분평균개선솔차이무통계학의의（P＞0．05），A조동통시각모의량표（visual analogue scale， VAS）평분、경추곡도여술전상비차이무통계학（P＜0．05），B조칙현저개선（P＜0．05）。술후1년B조JOA평분교술후1주현저강저（P＜0．05），B조여술전경추활동도적차치현저대우A조（P＜0．01）。수방기간，A조C5신경마비적발생솔위2．8％（1/36），B조위12．5％（3/24），차이유통계학의의（χ2＝3．35，P＜0．05）。결론2충방법조기도가취득량호적신경공능개선，재경추곡도、경통화활동도적영향상，량자각유우렬。
Objective To compare clinical results between laminoplasty and cervical laminectomy conbined fusion .Meth-ods The retrospective study analyzed the clinical data of 80 patients who needed surgical treatment due to the multi-level cer-vical myelopathy .The patients underwent Centerpiece laminoplasty were classified as Group A , while the patients underwent laminectomy and fusion were classified as Group B .The clinical and radiological results were evaluated through questionnaire and radiology examination .Results One week after surgery ,there were no significant differences in the improve rate of Japa-nese Orthopaedic Association(JOA) scores between 2 groups (P>0.05).There were no significant differences in visual ana-logue scale (VAS) scores and cervical curvature angle in Group A compared with preoperative (P>0.05),they get improved in Group B(P<0.05).One year after surgery, the JOA scores was showed significant differences in Group B compared with postoperative (P<0.05).Differences of range of motion between 1year after surgery and 1 week after surgery in Group B was significantly greater than that in Group A (P <0.01).The C5 nerve palsy incidence was 2.8% (1/36), Group B was 12.5%(3/24), and there were significant differences (χ2 =3.35, P<0.05).Conclusion Centerpiece laminoplasty and laminectomy conbined fusion can make good neurological improvement rate after short -term follow-up.Both have their pros and cons in the cervical curvature angle ,neck pain , and the range of motion .