颈椎单开门微型钛板间隔固定治疗脊髓型颈椎病

目的比较颈椎后路微型钛板间隔固定和全节段固定治疗脊髓型颈椎病的疗效。方法2009年10月至2012年10月对48例多节段脊髓型颈椎病患者行颈椎后路单开门椎板成形术治疗，其中A组28例行间隔微型钛板固定，B组20例采用全节段微型钛板固定，对两组患者术后神经功能改善JoA评分、术后开门角度、术后固定节段和不固定节段的门轴侧愈合率进行回顾性分析。结果平均随访18个月（12-32个月），神经功能JOA评分均获得满意的恢复，两种固定方式在神经症状改善率、术后开门角度、术后固定节段和不固定节段的门轴侧愈合率比较差异无统计学意义（P〉0．05）。结论颈椎后路微型钛板间隔固定在治疗多节段脊髓型颈椎病与全节段固定同样可以取得满意的疗效。

Objective To observe all levels and alternate levels plate fixation in expansive open door cervical laminoplasty for cervical spondylotic myelopathy. Methods 48 patients who underwent cervical laminoplasty with alternating levels plate fixation （ 28 patients in Group A ） or all levels plate fixation （ 20 patients in Group B ） between October 2009 and October 2012 were evaluated in our hospital retrospectively. JOA scores, open angle, fusion ratio of fixed segments and unfixed segments were assessed. Result The mean follow-up time is 18 months between 12 to 32 months. There were no significant differences between the 2 groups in terms of Japanese Orthopaedic Association （ JOA ） scores, JOA recovery rates postoperatively, open angle and fusion ratio of fixed segments and unfixed segments. Conclusion Alternate levels titanium miniplate fixation in expansive open door cervical laminoplasty for multiply segments of cervical spondylotic myelopathy is as effective as all levels of plate fixation.