微型钛板固定在改良单开门颈椎管成形术中的应用

Application of Miniplate Fixation in Modified Unilateral Open-door Cervical Laminoplasty

目的评价微型钛板固定法改良颈后路单开门颈椎管扩大成形术的临床效果。方法对35例需行颈后路单开门椎管扩大成形术的患者,术中将预弯成"Z"形的6孔微型钛板两端分别固定于开门后的椎板和门轴侧侧块,用以取代传统的小关节囊悬吊固定法。通过影像学方法观察所有病例的临床效果。结果本组患者未出现术中神经、血管损伤等并发症。所有患者术后随访6～24个月,平均13个月,影像学评估显示内固定确实,未见钛板及钛钉脱落移位、椎板塌陷或再关门现象。临床疗效按Odom评分标准:非常满意16例,满意9例,基本满意6例,不满意4例,总优良率为71.4%。结论微型钛板固定法改良颈后路单开门颈椎管扩大成形术操作简单,临床效果良好。

Objective To evaluate the clinical results of modified unilateral open-door cervieal laminoplasty using miniplate fixation. Methods Thirty-five patients were performed with unilateral open-door laminoplasty. A miniplate was fixed on the laminae and lateral masses during this operation after the laminae were opened.Retrospective analysis of the imaging data and clinical results of these cases were made.Results There was no neurological and vertebral artery injury due to the mini-plates fixation. The mean follow-up was 13 months （6-24 months）.The posterior CT scan showed there was no screw loosening and reclose of the opened laminae. The Odom grade was very good for 16 cases, good for 9 eases, fair for 6 cases and poor for 4 cases.The excellent rate was about 71.4%.Conclusion The modified unilateral open-door laminoplasty using m/niplate fixation has the advantage of easy performing, rigid fixation of elevated laminae and good clinieal results.