棘突-侧块锁定法改良颈后路单开门术的临床应用

The modified single open-door laminoplasty of cervical spine using spine lateral mass locking method and its clinical application

目的设计并评价棘突-侧块锁定法改良后路单开门椎管扩大成形术的疗效。方法在尸体上行单开门椎管成形术。在门轴一侧的侧块及棘突基底处分别钻孔，开门后用普通钛质皮质骨螺钉通过棘突孔和侧块孔将其固定，使椎板维持在开门状态。经尸体上试验成功后于2009-01-2013—06对13例脊髓型颈椎病行该手术。结果13例获得6—36个月，平均14．6个月的随访。无患者出现颈项部及肩背部疼痛和肌肉痉挛；僵硬感和活动受限；未见螺钉松动和再“关门”现象。也无其他并发症发生。结论棘突-侧块锁定法改良后路单开门椎管扩大成形术，操作简单，维持“开门”确切，近中期疗效满意。

Objective To design the modified single open-door laminoplasty using spine lateral mass locking method and evaluate its effect. Methods The single open-door laminoplasty was performed in cadaver. Holes were drilled on the side block and the fundus of the spinous process, respectively. And then the centrum were fLxed with common Titanium cortical bone screws through these holes, keeping the vertebral plate in the open state. Thirteen patients with cervical spendylotic myelopathy underwent this operation between Jan. 2009 and Jun. 2013 after the successful trial of the body. Results Thirteen patients were followed up for 6-36 months, with 14.6 months on average. There were no patients with neck and shoulder back pain and muscle spasms; rigid sense, and limitation of activity; there were no loose screws and again ＂closed-door＂ phenomenon, no other complications. Conclusion The modified single open-door laminoplasty using spine lateral mass locking method has satisfactory short-term and middle-term effects with simple operation and exact efficacy in keeping the door open.