摘要
目的探讨单开门颈椎管扩大成形单侧侧块内固定联合植骨术治疗颈椎伤病的可行性和疗效。方法利用单开门颈椎管扩大成形单侧侧块内固定联合植骨术治疗颈椎伤病患者16例,手术减压节段包括C3～5 3个节段2例,C3～6 4个节段5例,C3～7 5个节段9例。手术方式均采用单开门颈椎管扩大成形,门轴侧行侧块螺钉钢板内固定,并大量植骨。结果术中及术后均未发生脊髓、神经根及血管副损伤。全部患者平均随访18个月,术后3个月时JOA评分从术前的7.9分提高到13.1分。随访期间未见内固定物移位断裂及椎板再关门现象,门轴侧骨折处骨质融合。结论单开门颈椎管扩大成形单侧侧块内固定联合植骨术治疗颈椎伤病疗效安全可靠,经济实用,在椎管扩大成形获得即刻稳定的同时,提高植骨融合率,减少后凸畸形及失稳的发生率,减少椎板再关门现象。
Objective To evaluate the feasibility and effectiveness of open-door expansive laminoplasty and unilateral lateral mass fixation for cervical spondylotic myelopathy and cervical trauma. Methods Sixteen patients with cervical spondylotic myelopathy and cervical trauma were treated by combination of open-door expansive laminoplasty with unilateral lateral mass fixation and bone grafting. Cervical laminoplasty was carried out from C3-5 in 2 patients and C3-6 in 5 patients and C3-7 in 9 patient. Clinical and radiographic assessment was carried after surgery.Results were quantified using the Japanese Orthopaedic Association （JOA）scoring system to detemine function.Results There were no major complications such as neural or vascular injuries or breakage of implants .The follow -up period varied from 6 months to 3 years .average 18 months.The average JOA scores were 7.9 Points before surgery and 13.1 points 3 months after surgery,81.3% of the patients had obtained excellent or good results.In the period of follow-up ,there was no closure of opened laminae ,bone regrowth and fusion in the gutter of hinged side was shown.Conclusion The treatment of cevical spondylotic myelopathy and cervical trauma by combination of open-door expansive laminoplasty with unilateral lateral mass fixation and bone grafting is a safe ,effective,simple and practical methord.This combined surgical technique allows decompression of the spinal cord ,immediate intemal fixation by plate fixation,and subsequent long-term stabilization by bony fusion.
出处
《脊柱外科杂志》
2007年第1期4-6,共3页
Journal of Spinal Surgery
关键词
颈椎
内固定器
脊柱融合术
cervical vertebrae
internal fixators
spinal fusion
