FASTIN锚钉在颈椎单开门椎管成形术中的应用

Validity of FASTIN anchor in cervical laminoplasty

[目的]评价FASTIN锚钉在颈椎单开门椎管成型术(expansive open-door laminoplasty,ELAP)中的临床应用价值并报告其近期随访结果。[方法]2005年2月～2006年2月,89名因颈椎病行ELAP手术的患者纳入本次研究。其中40例使用FASTIN锚钉进行"门轴"侧固定的患者为研究组,另49例采用传统缝线悬吊"门轴"的患者设定为对照组。随访24个月,对术后临床和影像学指标作统计分析。[结果]术后24个月随访时两组间比较:手术时间,出血量,JOA评分增长率,颈椎前突指数,颈椎活动度均无明显差别,轴性症状发生率和C5神经瘫发生率锚钉组明显低于对照组(P<0.01)。研究组2例高龄患者术后6个月时出现了锚钉的松动,但随访全过程并没有影响手术效果。[结论]锚钉的使用避免了传统ELAP手术对于门轴侧小关节囊和椎旁肌肉的缝合干扰,有效降低了术后轴性症状的发生,但是对于高龄骨质疏松的患者锚钉的使用应该慎重。

[ Objective] To evaluate the efficacy and short-term results of FASTIN anchor in cervical expansive open-door laminoplasty （ELAP）. [ Method ] From February 2005 to February 2006, a total of 89 cases of cervical spondylotic myelopathy （CSM） were assessed in this study. Forty patients undergoing expansive open-door laminoplasty （ELAP） by FASTIN anchor were classified as study group. Fouty-nine patients undergoing conventional ELAP served as controls. The clinical results and radiological examinations of both groups were evaluated at 24 months after surgery. [ Result] There were no significant differences in operation time, bleeding quantity and recovery rate of Japanese Orthopaedic Association （JOA） scores. The incidences of axial symptoms and C5 palsy in the study group were significantly lower than those in the control group （ P 〈 0.01 ）. There were no significant differences in cervical curvature indexes and range of motion between the two groups. Loosening developed in 2 eids with osteoporosis but no neural lesion occurred during the follow-up. [ Conclusion ] The introduction of FASTIN anchor is an effective option to reduce the incidence of postoperative axial symptoms and C5 palsy through the low-invasive procedure to cervical facet articular capsule and paravertebral muscle,but for elderly patients with osteoporosis the usage of anchor must be cautious.