伊藤法“单开门”颈椎椎管扩大椎板成形术的并发症及其原因分析

The complications and their causative analysis of a modified single open door laminoplasty using Itoh method

目的:探讨伊藤法“单开门”颈椎椎管扩大椎板成形术并发症的发生率及其原因。方法:对1983年2月～1992年3月行伊藤法“单开门”颈椎椎管扩大椎板成形术的87例患者的临床资料进行回顾性分析,通过查阅病历及门诊随访,确定其手术并发症。采用临床观察、影像学评价及统计学方法分析其原因。结果:随访2～14年,平均5.3年。39例(45%)患者出现轴性症状,4例(4.6%)出现神经根麻痹,颈部旋转受限48例(55.2%),过伸受限33例(37.9%),屈曲受限17例(18.3%),侧屈受限17例(18.3%)。颈椎曲度:术前平均14.8°,术后平均4.9°,平均减少9.9°。结论:伊藤法“单开门”颈椎椎管扩大椎板成形术后轴性症状较多见,术后颈椎前凸减小,尤其是颈椎后凸可能是产生轴性症状的原因之一。

Objective：To explore the rate of the complications and their related causes of modified open door laminoplasty using Itoh method.Method：87 patients who underwent Itoh method laminoplasty between February 1983 and March 1992 were retrospectively analyzed.The postoperative complications were determined through checking the medical records and interviewing the patients.The related causes of complications were investigated by clinical observations,radiologic evaluation and statistic analysis.Result：Eighty-seven patients were followed up for 2 to 14 years,mean 5.3 years.Axial symptoms appeared in 39 cases（45%）,radiculopathy in 4 cases（4.6%）,cervical rotation was reduced in 48 cases（55.2%）,extension in 33 cases（37.9%）,flexion in 17 cases （18.3% ） ,lateral bending in 17 cases（18.3%）,respectively. The average cervical alignment decreased from 14.8° preoperatively to 4.9° postoperatively.Conclusion：Decrease of postoperative cervical lordosis, especially kyphosis may be one of the factors to cause axial symptoms after modified open door laminoplasty using hoh method.