颈椎管狭窄症保留伸颈结构的颈后路有限化单开门治疗效果探讨

Discussion of the treatment effect of finity single door laminoplasty with preservation of cervical posterior of flec-tion structure on cervical stenosis

目的：探讨颈后路有限化单开门治疗颈椎管狭窄症对保留伸颈结构的临床效果。方法选取颈椎管狭窄症患者40例，均为解放军第一五三中心医院骨科2012年5月至2013年5月收治，采用颈后路有限化单开门手术治疗，回顾性分析临床效果及观察对保留伸颈结构的作用。结果本研究患者术后行 JOA 评分，优8例，占20%；良19例，占47.5%；可13例，占32.5%。与术前比较，术后末次随访 JOA 评分明显降低，差异有统计学意义（P〈0.05）。手术时间（75.2±2.4）min，术中出血（204.3±2.3）ml，无颈5神经根损伤，无再关门等传统单开门的不良后果，对伸颈结构较好保留。结论应用颈后路有限化单开门治疗颈椎管狭窄症，可最大程度地维持颈背肌和颈半棘肌结构及功能的完整性，减少对颈椎稳定机制和颈椎后伸机制构成的破坏，对降低术后颈椎轴性症状率、保留颈椎活动度作用显著。

Objective To investigate the treatment effect of finity single door laminoplasty of cervical posterior to treat cervical stenosis on preservation of flection structure. Methods Forty cases of patients with cervical stenosis were se-lected. They were all admitted by the department of spine surgery of NO. 153 hospital of people’s liberation army from May 2012 to May 2013. They were treated by the treatment method of finity single door laminoplasty of cervical posterior. The clinical effects were reviewed and its effects on preservation of flection structure were observed. Results This group of pa-tients postoperative JOA score,excellent in 8 cases（20% ）;good in 19 cases,accounting for 47. 5% ;13 cases can be ac-counted for 32. 5% . Compared with the preoperative and postoperative last follow-up,JOA score was significantly lower, there were significant differences（P〈 0. 05）. The average operative time（75. 2 ± 2. 4）min,blood loss（204. 3 ± 2. 3） ml,without the fifth cervical nerve root damage,no traditional single door closed adverse consequence,for better retention extended neck structure. Conclusions The application of finity single door laminoplasty of cervical posterior in treating cervical stenosis,which can maintain the completeness of structure and function of the cervical dorsal muscles and semispi-nalis muscles at the greatest degree,reduce the damage of cervical stability mechanism and rear protraction mechanism and play a remarkable role in reducing the rate of postoperative cervical axial symptoms and retaining cervical range of motion.