带线锚钉在颈椎单开门手术治疗脊髓型颈椎病中的应用探讨

Suture Anchors in the Treatment of Cervical Spondylotic Myelopathy With Cervical Expansive Open-Door Laminoplasty

目的研究带线锚钉在颈椎单开门手术治疗脊髓型颈椎病中的应用及效果。方法将86名脊髓型颈椎病患者随机分成锚钉组和对照组,每组43人,锚钉组行颈椎单开门颈椎管扩大成型手术,使用带线锚钉进行门轴侧固定;对照组行单纯后路单开门手术。根据术后JOA评分,手术对生产生活质量的影响和影像学指标进行临床疗效评价比较。结果锚钉组患者在术中应用自制颈椎侧块锚钉固定时均未出现神经、血管损伤等并发症,术后随访平均JOA评分15.2,与术前及对照组比较改善效果明显,术后6个月仅3例仍有颈部轻度压痛,活动受限。影像学评估显示内固定牢靠,未见螺钉松动和再关门现象。结论在颈椎单开门手术治疗脊髓型颈椎病中应用带线锚钉固定操作简单易行,临床效果非常良好,同时有效降低了术后轴性症状的发生。

Objective To evaluate the clinical application of suture anchor fixation in the treatment of cervical spondylotic myelopathy with expansive open-door laminoplasty.Methods Eighty-eight cases with cervical spondylotic myelopathy were randomly divided into two groups,43 cases for each.Expansive open-door laminoplasty with suture anchor fixation was performed on the treatment group while open-door laminoplasty on the control group.The postoperative JOA scores and imaging data were used to evaluate clinical efficacy.Results There were no neurological or vertebral artery injuries after suture anchor fixation.The average postoperative JOA score was 15.2.There were only 3 cases developing slight axial symptoms six months after the operation.The evaluation of imaging data showed that the internal fixation was stable,with the absence of signs of screw loosening or re-closure of opened laminae.Conclusions The expansive open door laminoplasty with suture anchor fixation is convenient for clinical application and could reduce the occurrence of postoperative axial symptoms.