单开门颈椎椎管扩大成型术的远期疗效观察

Long term Results of Expansive Open door Laminoplasty of Cervical Spine

目的 了解单开门颈椎椎管扩大成型术治疗颈椎椎管狭窄症的远期效果。方法 对９８ 例颈椎椎管狭窄症患者施行了单开门颈椎椎管扩大成型术，其中６１ 例获得随访，平均随访１１ 年８ 个月。结果 颈椎后纵韧带骨化症（ＯＰＬＬ） 组３２ 例，发育性颈椎椎管狭窄（ＤＣＳ） 组２０ 例及脊髓型颈椎病（ＣＳＭ）组８ 例，三组均在术后３ 年时疗效最佳，ＪＯＡ 评分平均改善率分别为７２ ．３０ ％ 、６７．８０％ 和６７ ．７４ ％ 。在术后随访平均１１ 年８ 个月时，ＪＯＡ评分改善率分别为６６．８１ ％ 、６６ ．５７％ 和６６．１０％ 。随访时Ｘ线检查未见颈椎不稳及再关门。结论 单开门颈椎椎管扩大成型术治疗由多种原因所致的颈椎椎管狭窄症的远期疗效良好且稳定，对颈椎的稳定性无影响。

Objective\ To observe the long term results of expansive open door laminoplasty of cervical spine for cervical spinal stenotic myelopathy.Methods\ From April 1986 to March 1988, 98 cases were operated upon with expansive open door laminoplasty of cervical spine. Sixty one cases had been followed up for an average of 11 years and 8 months. The long term results were analyzed.Results\ The best results were obtained at the third year after operation among the OPLL (32 cases),DCS (20 cases) and CSM (8 cases),with an average JOA recovery rate for an average of 72.30%in OPLL, 67.74%in DCS and 67.80%in CSM. JOA recovery rate were 66.81%in OPLL, 66.57%in DCS and 66.1%in CSM at following up for an average of 11 years and 8 months. Instability of the cervical spine and reclosed open door were not found at the follow up for an average of 11 years and 8 months.Conclusion\ The long term results of expansive open door laminoplasty of cervical spine for cervical spinal myelopathy were good and stable. Expansive open door laminoplasty of cervical spine did not affect the stability of cervical spine.\;