单侧椎板成形与全椎板切除术后C_5神经根麻痹发生率分析

Analysis of postoperative C_5 palsy prevalence post laminectomy and laminoplasty

目的探讨颈椎后路全椎板切除辅助钉棒系统固定与后路单侧椎板成形辅助微型钢板固定术后C5神经根麻痹发生率及其他手术相关并发症差异。方法回顾性分析因本院行颈后路减压手术患者105例,其中49例患者行后路全椎板切除辅助钉棒系统固定,56例患者行后路单侧椎板成形术微型钢板内固定术。所有患者手术前后均进行日本骨科学会(Japanese Orthopaedic Association,JOA)评分及影像学评估。结果 2组患者术后C5神经根麻痹发生率差异有统计学意义(P<0.05)。2种手术方式神经功能改善率差异无统计学意义(P>0.05)。结论 C5神经根麻痹发生可能与术后颈髓漂移造成神经根牵拉有关。单侧椎板成形辅助微型钢板固定并发症较少,但单侧椎板成形术对颈椎没有矫形作用。

Objective To investigate difference of C5 palsy and other complications between taminectomy and laminoplasty. Methods A total of 105 patients with ossification of posterior longitudinal ligament treated in our hospital were involed in this study, in which 49 patients underwent laminectomy and 55 patients underwent laminoplasty. The Pre- and post-operative Japanese Orthopaedic Association（JOA） score and radiologic data were assessed. Results The prevalence of post- operative Cs palsy was significantly higher in laminectomy group （ 18.9% ） than laminoplasty group （7.1% ）, the difference was statistically significant （P 〈 0.05 ） ; and the statistically significant difference of spinal cord shift were found between 2 groups. But there was no statistically significant difference of neurologic function recovery rate between 2 groups. Conclusion The incidence of C5 palsy post posterior decompression may be associated with spinal cord shift. Laminoplasty may not suitable for patients with cervical instability or kyphosis.