Centerpiece钛板在颈椎单开门椎管成形术中的应用

Validity of Centerpiece Titanium plate in cervical laminoplasty

目的探讨Centerpiece钛板内固定在单开门颈椎管扩大成形术的临床应用。方法选取2010年1月~2013年1月于福州总医院476医院56例行单开门椎管扩大椎板成形术的患者,按照手术方式分组,其中26例使用Centerpiece钢板行门轴侧固定的患者为观察组,30例采用传统缝线悬吊门轴的患者为对照组。对两组临床和影像学指标作统计分析。结果两组患者均获随访,随访时间13~32个月。手术时间两组比较差异有统计学意义（P〈0.05）,出血量两组比较差异无统计学意义（P〉0.05）。观察组术前、术后1周时JOA评分比较差异有统计学意义（P〈0.05）,对照组术前、术后1周时JOA评分比较差异具有统计学意义（P〈0.05）。两组术后1周时椎管面积比较差异无统计学意义（P〉0.05）。末次随访时椎管面积改变、颈椎活动度、颈椎曲度改变两组比较差异均有统计学意义（P〈0.05）。结论 Centerpiece钛板内固定应用在单开门颈椎管扩大成形术中是安全有效的,椎板开门后获得即刻稳定,可以恢复椎管的完整性。

Objective To explore the clinical application of Centerpiece Titanium plate fixation in open door lamino- plasty. Methods From January 2010 to January 2013, 56 cases given expansive Open-door lain inoplasty （ELAP） were seleted and divided into two groups. 26 cases with ELAP by Centerpiece titanium plate were as study group, 30 cases with conventional ELAP were as control group. The clinical and radiological exam results were evaluated. Results All Patients were followed-up for 13-32 months. There was a statistically significant difference in operation time of two groups （P 〈 0.05）. There was no significant statistically differences in blood loss of two groups （P 〉 0.05）. The JOA scores one week after operative of study group and control group increased obviously than those before the operation, the differences were statistically significant （P 〈 0.05）. There was not statistically significant difference in Cervical cross-sectional spinal area of two groups one week after operative （P 〉 0.05）. At last follow-up, Cervical cross-sectional spinal area, range of motion （ROM） and Cervical curvature index （CCI） of control group were significantly decreased than those of study group, the differences were statistically significant （P 〈 0.05）. Conclusion Clinical application of Centerpiece titanium plate fixation in open door laminoplasty is safe and effective, while vertebral plate is elevated and obtain instantly stability, at the same time , the integrity of spinal canal is also recovered.