汪 雷,李 涛,宋跃明,刘 浩,裴福兴,刘立岷,龚 全,孔清泉,曾建成.单开门颈椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症的早期临床疗效[J].中国脊柱脊髓杂志,2011,(8):654-658. |
单开门颈椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症的早期临床疗效 |
中文关键词: 颈椎管狭窄症 椎管扩大成形术 单开门 Centerpiece钛板 内固定 疗效 |
中文摘要: |
【摘要】 目的:探讨单开门颈椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症的早期临床疗效。方法:2009年8月~2010年6月采用后路C3~C7单开门椎管扩大成形Centerpiece钛板内固定术治疗颈椎管狭窄症患者30例,其中男性23例,女性7例,年龄42~81岁,平均65.2岁。MRI显示3个节段狭窄9例,4个节段狭窄15例,5个节段狭窄6例。以JOA评分(17分法)及其改善率评价术后神经功能改善情况;术后复查颈椎X线、CT及MRI,在术前及术后3d、6个月的颈椎侧位X线片上测量C5节段椎管矢状径,计算椎管扩大率[(术后椎管矢状径-术前椎管矢状径)/(术前椎管矢状径)×100%],评价椎管扩大和维持情况及门轴侧骨融合情况。结果:手术时间为145±20min,术中出血量为215±75ml,术中未出现相关并发症。1例术后第2天出现C5神经根症状,经2周保守治疗疼痛明显缓解,术后2个月时症状完全消失。随访9~20个月,平均14.6个月,术前JOA评分为8.7±0.8分,术后6个月为15.2±1.1分,改善率为(75±8)%。影像学复查示术后3d、6个月时颈椎管扩大满意,脊髓受压完全解除,C5节段椎管矢状径术前为9.2±0.8mm,术后3d、6个月均为15.9±1.2mm,椎管扩大率为(71.8±11.0)%。术后6个月时门轴侧均达骨性愈合,无1例出现关门及神经损害症状加重的情况。结论:单开门颈椎管扩大成形Centerpiece钛板内固定术是治疗颈椎管狭窄症的一种简便、安全的方法,早期疗效较满意。 |
Early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis |
英文关键词:Cervical spinal stenosis Expansive laminoplasty Unilateral open-door Centerpiece titanium plate Internal fixation Efficacy |
英文摘要: |
【Abstract】 Objective:To evaluate the early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis.Method:From August 2009 to June 2010,30 cases suffering from cervical spinal stenosis underwent unilateral open-door expansive laminoplasty plus centerpiece fixation,of these,there were 23 males and 7 females,with a mean age of 65.2 years(range, 42-81 years).Preoperative MRI showed stenosis at three levels in 9 cases,four levels in 15 and five levels in 6.The neurofunction was evaluated by Japan Orthopaedic Association(JOA) score;X-ray,CT and MRI were used to evaluate postoperative spinal canal enlargement and bone fusion at the hinge side.The sagittal diameter of C5 spinal canal on the lateral X-ray was measured before operation and 3 days,6 months after operation respectively,and the expansion rate of spinal canal was termed [as(postoperative sagittal diameter-preoperative sagittal diameter)/(preoperative sagittal diameter)×100%].Result:The average operation time was 145±20min;the average intraoperative blood loss was 215±75ml;no complications was noted during operation.C5 palsy was noted in 1 case 1 day after operation,which was relieved significantly after 2 weeks of correspondent intervention and resolved completely 2 months after operation.All patients were followed up for 9-20 months(mean 14.6 months). The average JOA score for preoperation was 8.7±0.8 and 15.2±1.1 at 6 months after operation,with the improvement rate of (75±8)%.Radiographic findings showed spinal canal enlarged perfectly at 3 days and 6 months after operation.The mean sagittal diameter of C5 spinal canal was 9.2±0.8mm before operation and 15.9±1.2mm at 3 days and 6 months after operation,with the expansion rate of (71.8±11.0)%.CT scan showed bony fusion at hinge side at 6 months after operation without recurrence of cervical stenosis and neurofunction deterioration.Conclusion:Unilateral open-door expansive laminoplasty plus centerpiece titanium plate fixation is simple and reliable,and the early clinical efficacy is satisfactory. |
投稿时间:2011-04-13 修订日期:2011-05-28 |
DOI:10.3969/j.issn.1004-406X.2011.8.654.4 |
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