双开门椎管扩大成形与羟基磷灰石植入治疗颈椎管狭窄症22例

Treatment of stricture of cervical vertebra tube by double-door vertebra tube amplification plasty with hydroxyapatite implantation.

目的 :探讨双开门颈椎管扩大、椎板成形与羟基磷灰石植入治疗颈椎管狭窄症的临床疗效及远期效果。方法 :22例颈椎管狭窄症采用双开门椎管扩大、椎板成形 ,将羟基磷灰石特制成多孔长方形锥台体植于劈开之棘突间 ,7号丝线固定。术后随访6个月～28个月 ,平均18 6月。据手术前后X线片、CT、MRT对比其手术前后椎管矢状径、椎管指数及颈脊髓功能评价 ,随访羟基磷灰石植入后新生骨长入及骨融合情况。结果 :22例颈椎管矢状径术前 (9 8±1 32)mm ,术后 (13 8±1 30)mm颈脊髓功能 (40分平分法 )术前20 1±4 8 ,术后32 5±2 7。术后3～6个月羟基磷灰石与棘突骨性融合 ,无感染、移位、脱落。结论 :双开门椎管扩大成形与羟基磷灰石植入治疗颈椎管狭窄症不仅颈椎管扩大及颈脊髓功能改善均明显 ,脊髓减压彻底 ,并发症少 ,而且减少硬脊膜粘连 。

Objective:TO study the clinical curative effect and forward effect of double-door vertebra tube amplification plasty with hydroxyapatite implantation for treating the stricture of cervical vertebra tube.Methods:Twenty-two patients with stricture of cervical vertebra tube were treated by double-door amplification plasty with hydroxyapatite implantation.All patients were fixed with silk suture NO.7.The follow-up of all patients was made from 16 to 28 months,the averge was 18.6 months.According to the contrast results of x-photogram.CT scam and MRI before and after operation,the sagittal path and index of vertebra tube.function of cervical vertebra were evaluated.Regeneration and healing of bone were observed in routine.Results:In all twenty-two patients,the cervical vertebra tubes were enlarged from (9.8±1.32)mmto (13.8±1.30)mm,the functions of cervical vertebra were significantly improved from 20.1±4.8to32.5±2.7.New bone grew into hydroxyapatite and bone healed from 3 to 6 month,the infection,displacement and defluxion were not found.Conclusion:Double_door vertebra tube amplification plasty with hydroxyapatite implantation for treating the stricture of cervical vertebra tube is most effective.decompression completeness and less complication.Above mentioned operative method not only enlarges vertebra tube and improves the function of cervical Vertebra,It also decreases adhesion of dura mator spinalis and prevents restricture of vertebra tube.