C_2棘突肌肉止点重建对颈椎管成形术后轴性症状的影响

Clinical application of the modified open-door laminoplasty rebuilding posterior extensor musculature inserted into C_2 spinous process

目的探讨颈椎管减压成形手术对改善术后颈椎轴性症状的临床效果。方法回顾性分析2008年3月～2009年12月我院28例行重建C2肌肉止点的颈椎管成形术和20例行传统颈椎管成形术患者术前、术后2个月及末次随访时JOA评分改善率,颈椎轴性症状发生率,并对结果进行比较评估。结果重建C2肌肉止点组和传统手术组在术后2个月及末次随访时JOA改善率无明显差异,但轴性症状的发生率明显低于传统手术组。结论颈椎后路手术中应尽量减少对椎旁肌肉的破坏,重建C2棘突肌肉止点的改良术式能够最大限度地恢复颈部伸肌的完整性,与传统手术相比虽神经功能恢复差别不大,但能够明显降低术后轴性症状的发生率。

Objective To assess the effect of modified opendoor laminoplasy rebuilding posterior extensor musculature inserted into C2 spinous process and to determine whether it can reduce the axial syndrome. Methods 28 patients undergoing modified cervical expansive opendoor laminoplasty rebuilding the posterior extensor musculature inserted into C2 spinous pro cess and 20 patients undergoing traditional way were investigated in preoperative, two months postoperative and last time of followup. To assess the effects of two different cervical laminoplasty types in the recovery rate of JOA score ,the changes of axial syndrome ,and analyzed the results to find the difference in the two stypes. Results There were no difference in the recovery rate of JOA score according to the two groups. The group of rebuilding the posterior extensor musculature inserted into C2 spinous process had fewer patients suffering the axial syndrome in followup. Conclusion Rebuilding the posterior extensor muscula ture inserted into C2 spinous process can reduce the incidence of postoperative axial syndrome.