Centerpiece钛板在颈椎后路单开门椎管扩大成形术中的应用及疗效分析

Clinical application and efficacy of Centerpiece titanium plate in cervical expansive open-door laminoplasty

目的 评价颈椎后路单开门椎管扩大成形术中Centerpiece钛板的临床应用及疗效。方法 自2010-03-2011-12采用Centerpiece钛板内固定术治疗34例颈椎疾患。结果 手术时间为（140±15）min,术中出血量为（275±25）ml。所有患者获得随访8-18个月,平均8.5个月,1例出现C5神经根麻痹,1例出现螺钉松动,5例出现轴性症状。术前JOA评分为（9.8±2.9）分,末次随访时为（15.3±1.1）分,改善率达（65.4±9.3）%。影像学复查示C5节段椎管矢状径术前（10.4±1.5）mm,末次随访时为（15.6±1.4）mm,椎管扩大率为（68.3±8.9）%。C5节段脊髓后移（3.13±1.82）mm,与术前比较差异有统计学意义（P〈0.05）。颈椎Cobb角术前为（13.1±1.6）°,末次随访时为（11.3±1.8）°,术前与末次随访时比较,差异无统计学意义（P〉0.05）。结论 Centerpiece钛板应用于颈椎单开门椎管扩大成形术安全有效,术后神经功能恢复良好,早期疗效满意。

Objective To explore the clinical application and efficacy of Centerpiece titanium plate fixation in open door laminoplasty. Methods A total of 34 patients received the unilateral open-door cervical expansive laminoplasty fixed by centerpiece plate from March 2010 to December 2011. Results The average operation time was （140±15）min, the average intraoperative blood loss was （275±25）ml. All patients were followed up for 8-18 months（mean 8.5 months）. C5 palsy was noted in 1 case at 3 day after operation, 1 case oceurcd screw loosening, 5 patients got axial symptoms. The average preoperative JOA score was （9.8±2.9） and （15.3±1.1） at final follow-up after operation, with the improvement rate of （65.4±9.3）%. The mean sagittal diameter of C5 spinal canal was （10.4±1.5）mm before operation and （15.6±1.4）mm at final follow-up,with the expansion rate of （68.3±8.9）%. Cervical curvature index was （13.1±1.6）% preoperatively, it was （11.3±1.8）% at final follow-up interval, indicating that cervical curvature index made no progress at final follow-up interval （P 〉0.05）. Conclusion Unilateral open-door expansive laminoplasty plus centerpiece titanium plate fixation is reliable, nerve recovery and the early clinical efficacy is satisfactory.