摘要
目的通过椎管扩大面积的理论计算和调查实际椎管扩大率与术后效果的关系,为手术的术式提供技术性依据。方法设计对椎管扩大面积进行理论计算的方法,对630椎的理想椎管扩大率进行测量和模拟计算。回顾126例施行颈椎双开门手术病例和影象资料,调查人工椎弓和侧沟的位置,椎管扩大率,好转率,根据人工椎弓的不同位置将126例分为3群并进行比较。结果在人工椎弓宽度10㎜时平均理想扩大率为49.6%;宽度12㎜时为58.5%;宽度14㎜时为69.1%。A群56例人工椎弓位置平均值为1.2㎜±0.6;B群42例为2.8㎜±0.6;C群28例为5.6㎜±1.4。各群平均值间有明显差异(P<0.05)。平均改善率A群70.4%,B群58.5%,C群43.3%,各群间有明显差异(P<0.05),扩大率与改善率成正相关关系。结论使用12㎜人工椎弓,且人工椎弓位置值在2㎜以下的病例手术效果良好。人工椎弓位置对椎管扩大率的影响较大。骨化占据率60%以上的病例,应使用14㎜人工椎弓或采用其他术式。
Objective To analyze the correlation between the position of spacer (PS) and the surgical results and to select appropriate spacer by the calculation of spinal canal area in the double-door laminoplasty of the cervical stenosis. Method The 126 patients with cervical stenosis were investigated. The PS, actual transverse distance and spinal canal area were measured by reviewing the pre/post-operative CT or MRI. The spinal canal enlargement rate (ER) was calculated. The 126 patients were divided into three gro...
