侧块螺钉在颈椎病单开门手术中的应用

Clinical Application of Cervical Spondylotic Myelopthy and Cervical Trauma with Lateral Mass Screw in the Open-door Surgery

目的:探讨侧块螺钉在颈椎单开门手术中应用的临床经验。方法:对2000年2月至2007年8月间共38例行侧块螺钉固定的患者进行随访分析。36例患者中发育性颈椎管狭窄19例,长节段后纵韧带骨化合并黄韧带钙化8例,颈椎多节段退变压迫脊髓8例,多节段颈椎不稳6例,颈椎前路术后行2次手术1例,无骨折脱位脊髓损伤4例。结果:本组38例中36例(94.7%)获得随访,术后随访6月-7年,平均随访3年。脊髓功能Frankle分级均有不同程度的恢复:A级恢复至B级1例,B级恢复至C级1例,恢复至D级1例。有C级恢复恢复至D级4例,完全恢复2例:D级24例级完全恢复。结论:颈椎侧块螺钉固定能改善颈痛,能提供较稳定的固定,避免再关门,是颈椎后路单开门辅助治疗十分有效的方法。

Objective： To explore the clinical experiments of the open--door application of cervical spondylotie myelopthy and cervical trauma with lateral mass screw. Method： From February 2000 to August 2007 ,38 cases were treated with lateral mass screws. 36 cases of cervical spondylotic myelopthy and cervical trauma included 19 cases with congential cervical spinal cord stenosis; 8 cases complicated with long--segment ossification posterior longitudinal ligament calcification; 8 cases complicated with multi--level cervical myelopathy ; 1 case after anterior opertation; 4 cases of cervical spinal cord injury without fracture or dislocation. Result： 36 cases were followed--up for an average of three years（range from 6 months to 7 years）. 36 cases had different degrees of restoration according to Frankle grade methods, of which there one case was made recovery from A level to B level, one from B level to C level, one from B level to D level, four from C level to D level, two from C level to E level, twenty four from D level to E level. Conclusion： Operation with posterior and lateral mass screw fixation can relieve pain , stabilize the spine, avoid closure of opend luminae. The method is an effective fixation for posterior operation.